For a long time hemorrhage, obstructive vomiting and a certain characteristic localized pain were regarded as the essential symptoms of gastric ulcer, and when these classical symptoms were absent this lesion was diagnosed and treated (or mistreated) under other and various names that rarely conveyed any idea of the real causative pathology. In the light of our present knowledge, we must believe that our firm but unfounded faith in these diagnostic tests excluded from rational treatment a large majority of all our cases and persuaded us to make chronic gastritis, gastralgia and dyspepsia responsible for much suffering and not a few deaths that should properly be charged to gastric ulcer.
It was not until the recent advances in stomach surgery permitted us often to observe and study gastric ulcer in life on the operating table that we were made to realize the great frequency and grave importance of this lesion.
NILES HD. THE EARLY DIAGNOSIS OF GASTRIC ULCER.. JAMA. 1905;XLV(17):1217–1218. doi:10.1001/jama.1905.52510170009001a