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December 24, 1949


Author Affiliations

Los Angeles

JAMA. 1949;141(17):1208-1213. doi:10.1001/jama.1949.02910170010003

Except for the female generative system, symptomatic bleeding originates most commonly from the gastrointestinal tract. Hemorrhage from this source is manifest by hematemesis, the vomiting or regurgitation of blood, or by melena, which is the discharge of black, modified blood from the bowel. Although it is customary to discuss these two symptoms together, we have found it both expedient and enlightening to study them separately. The present study is a statistical analysis of primary pathologic conditions in 293 cases in which melena was a prominent symptom. It is an extension of a previous report1 on the underlying causes of hematemesis as a manifestation of gastro-intestinal bleeding. A discussion of the clinical features and treatment of conditions associated with hematemesis is reported elsewhere.2

Melena is defined as the discharge from the bowel of black, altered blood, but in this paper the broad meaning of the term will be used