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July 1949


Author Affiliations

From the Department of Surgery, Johns Hopkins Hospital.

Arch Surg. 1949;59(1):37-56. doi:10.1001/archsurg.1949.01240040040002

AMONG the many wound stripes incident to modern civilization perhaps the one which looms most prominent yet remains most perplexing is the problem of peptic ulcer and its perilous complications. About 8,800 persons die annually in the United States alone from the sequelae of peptic ulcer, and massive hemorrhage due to ulcer is a grim contributor to this excessive toll.

Recent therapeutic procedures in the treatment of peptic ulcer have produced many changes of opinion. However, there still remains much controversy over the treatment of gastroduodenal bleeding. Is surgery indicated and, if so, for which patients? When is the optimal time to operate and what is the operation of choice? What is the present status of transfusions and parenterally administered fluids? Is morphine contraindicated? Is it best to feed patients promptly or to starve them?

What is the current trend in antacid therapy? Are amino acids helpful? Is vagotomy the

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