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Article
April 2, 1927

DIFFERENTIAL DIAGNOSIS BETWEEN GASTRIC AND DUODENAL ULCER AND GALLSTONES

Author Affiliations

Professor of Clinical Surgery, Vanderbilt University Medical Department; Surgeon, St. Thomas Hospital NASHVILLE, TENN.

JAMA. 1927;88(14):1050-1053. doi:10.1001/jama.1927.02680400006002

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Abstract

Ulcer of the stomach and duodenum, if attended with typical symptoms of pain, vomiting and hemorrhage of ascertainable degree and accuracy of occurrence, is a very definite and easy diagnosis. An outspoken attack of severe biliary colic, so characteristic of gallstones, is not to be confused with any other lesion, as the condition is so dramatic and the symptoms so compelling that there is little room for doubt. Compared to the total number of cases of both diseases, the textbook symptoms are comparatively rare. The great majority of gastric and duodenal ulcers, as well as the multitudinous cases of gallstones and its associated lesions, are not easy of detection. Many times the symptoms are overlapping and confusing. The language of disease, when its diction, intonation and phraseology are perfect, is easily understandable. Unfortunately, it is often whispered and many times in an alien tongue. Language is said to conceal thought,

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