The preoperative preparation and the postoperative care of patients with carcinoma of the stomach have assumed increasing importance during the past decade, and during this period there has been a steady decline in the mortality associated with radical gastric resection. The importance of the nonoperative phases of management is now so clearly understood that no surgeon interested in this type of surgery would consider operation without at least attempting to correct certain of the abnormalities which exist in nearly every instance when the patient comes for resection. THE PATHOLOGIC PHYSIOLOGY OF GASTRIC CANCER The parietal cells of the gastric mucosa normally secrete hydrochloric acid at a concentration of about 165 millimols or 0.6 per cent. A variety of mechanisms are probably involved in the process of neutralization, so that the actual acidity of the gastric contents varies widely in the same person from time to time and in different persons.