Subtotal gastrectomy for carcinoma of the stomach has established itself as a procedure of relative safety with excellent results for the cure of malignant conditions. The indications for and advisability of total gastrectomy for carcinoma of the stomach, and the postoperative results, present many interesting problems for investigation. Chief among these is the effect of the loss of the acid and chloride normally secreted by the stomach and the explanation of the secondary anemia, which has been reported by W. J. Mayo1 and by Moynihan2 as having occurred as long as three years after operation.
At the Mayo Clinic, operations have been classified as instances of total gastrectomy only if no portion of the stomach has been allowed to remain. Those in which even the smallest amount of gastric wall has been allowed to persist have been grouped as instances of subtotal gastrectomy. The reason for this sharp