It has been frequently pointed out that in the study of the etiology of peptic ulcer one cannot be content with viewing this affection simply as a local disease limited to the stomach and duodenum, but that some systemic disturbance may be largely accountable for the chronicity of the local manifestation. Whatever the remote cause may be, whether due to infection, disturbances of the nervous or endocrine system, anemia, syphilis or other systemic conditions, the ultimate result consists in a localized destruction of the mucous membrane varying in degree according to its chronicity, surrounded by undermined edges with proliferation of connective tissue, thickened walls, and a base consisting largely of a thin layer of muscularis or somewhat thickened serosa. It has also been demontrated by Smithies, and more recently by Crohn, that chronicity bears but little relation to the time element in the formation of ulcer and that chronic ulcers
FRIEDENWALD J, LOVE WS. RAYNAUD'S DISEASE COMPLICATED WITH GASTRIC ULCER: REPORT OF CASE. JAMA. 1925;85(2):83–85. doi:10.1001/jama.1925.02670020003003
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