The more we can learn about peptic ulcer, the more accurate we can be in the recognition of its type, activity and microscopic changes; and the better we understand the complications, the more intelligently we can advise treatment for individual cases.
Surgical treatment for peptic ulcer probably offers the better chance for rapid and permanent cure, particularly in complicated cases, but certain patients respond well to nonsurgical measures and remain entirely without symptoms for an indefinite period. Some patients with peptic ulcers fail to benefit permanently, or perhaps even temporarily, from a medical regimen. In some of these patients the reasons for failure are that the ulcer which is being treated is a penetrating lesion, or perhaps it is one in which obstructive features are easily recognizable. A carefully taken history usually will include information from which fairly accurate deductions regarding the microscopic changes of a lesion can be obtained.
HARTMAN HR, RIVERS AB. BENIGN GASTRIC AND DUODENAL ULCERSCLINICAL DIAGNOSIS AND THE CONDITIONS FOUND AT OPERATION. Arch Intern Med (Chic). 1929;44(3):314-338. doi:10.1001/archinte.1929.00140030013002