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December 3, 1938


Author Affiliations

Assistant Clinical Professor of Medicine, Columbia University, Attending Physician, the Roosevelt Hospital NEW YORK

From the Gray Service, the Roosevelt Hospital.

JAMA. 1938;111(23):2071-2076. doi:10.1001/jama.1938.02790490001001

Chronic ulcerative colitis remains one of the most controversial problems in the field of disorders of the gastrointestinal tract. Opinion is divided with respect to classification. There is marked divergence of opinion concerning the natural history of the disease and its prognosis. There is no agreement concerning etiology, and no uniformity in the various philosophies of treatment.

It is apparent from the literature that the criteria for classification must be altered. There has been and still is a school of thought which regards the associated bacterial flora as the fundamental index rather than the anatomic and physiologic changes which the disease produces. Thus, by the operation of such a system of nomenclature, the isolation of Shigella dysenteriae in a case presenting chronic inflammatory lesions of the colon automatically excludes the case from the group styled chronic ulcerative colitis. Such arbitrary subdivision is made without respect to the pathology, physiology or

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