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November 28, 1931

The Causation of Chronic Gastro-Duodenal Ulcers: A New Theory.

JAMA. 1931;97(22):1646. doi:10.1001/jama.1931.02730220068034

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The author presents a new theory of the causation of peptic ulcer. In all the previous discussions on the etiology of ulcer formation, the factor of food was not considered, except so far as the simple points that it must be well comminuted and that it must prevent the formation or reduce the amount of free hydrochloric acid. He brushes aside the many theories presented by showing the lack of value of any of these in the treatment. Gastro-enterostomy is followed by a high percentage of gastrojejunal ulcer, and resection is fraught with too high a mortality. He states from his perusal of the literature that fats delay digestion and at first depress but later increase the secretion of gastric acidity. Bile has no function in reducing acidity. Quoting some recent work of MacLean, he further states that duodenal regurgitation has on the whole no influence on gastric acidity. Bile

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