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December 10, 1938


JAMA. 1938;111(24):2198-2201. doi:10.1001/jama.1938.72790500003009

Gastric hemorrhage is a dramatic event. When a person vomits bright red blood or passes a large tarry stool and when in either event he experiences the sickening weakness which accompanies hemorrhage, he usually knows what to do. He calls his doctor. Until a few years ago the doctor, with rare exceptions, thought he also knew what to do. He instituted treatment based on starvation and sedation.

I propose to discuss the problem of gastric hemorrhage from the standpoint of treatment, and as a surgeon I shall confine my discussion to the type of hemorrhage for which the value of surgical intervention is becoming recognized, namely bleeding peptic ulcer. Peptic ulcer, according to Bulmer,1 causes 89 per cent of acute hemorrhages from the upper part of the intestinal tract, 5.3 per cent of such hemorrhages being caused by esophageal varices and 1.5 per cent by gastric carcinoma. Owen,2

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