When a person first has gastric symptoms, he may be experiencing the full impact of a short-lived, self-terminating, and indeed trivial disorder, or he may be experiencing the introduction to a long and complicated series of events that will terminate only with death. Between these extreme situations is a vast field of human reactions and medical knowledge that may directly influence the course of the illness and determine its outcome. In this study an effort will be made to consider these various factors, particularly in their relation to that most serious of all gastric diseases, cancer. PATIENTS The average person in his first encounter with gastric symptoms will not seek medical advice unless he has pain, vomiting, or gastric hemorrhage. If any of these are prominent, he will usually go to a physician in the first 24 hours. If these symptoms are transient or mild, or if the presenting symptoms