We may say that surgical opinion has crystallized on some phases of ulcer, is crystallizing upon others and in some phases is still chaotic. The treatment of such complications as perforation and subphrenic abscess admits of no discussion whatsoever and may definitely be put to one side. Both must be met by prompt operative procedure, and it is not a question of whether to operate, but how. So far as hemorrhage is concerned there is honest room for doubt, and the variety of ulcer, its acuteness or chronicity, the amount of the hemorrhage, its recurring nature and the size of the vessel involved must be considered before a conclusion can finally and rightly be made. There is a greater difference of opinion between internists and surgeons as to the treatment of non-perforating, non-hemorrhagic ulcers with disabling adhesions and other gastric disturbances, purely mechanical in nature, following in their wake.
RODMAN WL. GASTRIC AND DUODENAL ULCERS.WHEN DO THEY REQUIRE SURGICAL TREATMENT AND WHAT PROCEDURES ARE NECESSARY?. JAMA. 1906;XLVII(11):842-845. doi:10.1001/jama.1906.25210110026002f