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Article
January 16, 1954

DUODENAL ULCER

JAMA. 1954;154(3):244. doi:10.1001/jama.1954.02940370056019
Abstract

The concept that duodenal ulcer is in some way due to the stresses and strains of modern life has continued to interest physicians since Harvey Cushing focused attention on this problem by his paper "Peptic Ulcer and the Interbrain" in 1932. Many physicians have called attention to the high incidence of ulcers in persons whose occupations subject them to continuous mental strain, worry, and anxiety and to the tendency for exacerbations to occur during periods of emotional stress. Dragstedt postulated that these events cause a hypertonus in the secretory and motor fibers in the vagus nerves, resulting in hypermotility and an excessive continuous secretion of gastric juice in the empty stomach, with ulcer formation. The abolition of this hypersecretion and concomitant healing of duodenal ulcer following complete gastric vagotomy in many cases has supported this point of view.

Recently, Gray and his associates1 suggested an alternate mechanism by means

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