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May 4, 1935


JAMA. 1935;104(18):1637-1638. doi:10.1001/jama.1935.02760180069017

The circulatory theory of the genesis of gastric ulcer advanced by Virchow and Hauser in 1853 suggested that such ulcers are produced by an infarction of a terminal blood vessel with consequent necrosis, the starting point for the digestive action of the gastric juice. In this theory the rôle of the excessive gastric secretion assumed especial importance and was considered the decisive factor by Riegel, Boas, Sippy, von Bergmann and, in fact, the majority of clinicians.

Chronic ulcers, it was pointed out, occur only in that portion of the gastro-intestinal tract which is exposed to the action of the hydrochloric acid; viz., the stomach and the first two. inches of the duodenum. They are rare in the cardia. When the jejunum is exposed to the action of gastric juice following a gastro-enterostomy for ulcer, marginal peptic ulcer develops not infrequently. However, such ulcer has never been observed when the gastro-enterostomy

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