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May 19, 1917


Author Affiliations

Clinical Professor of Medicine, Leland Stanford Junior University, School of Medicine SAN FRANCISCO

JAMA. 1917;LXVIII(20):1464-1470. doi:10.1001/jama.1917.04270050166006

In textbooks, diseases of the stomach are classified with apparent ease; but in practice one soon learns that cases are not fitted so readily into the place in which they belong. In fact, the decision as to what an individual case of "stomach trouble" really means from the standpoint of pathology is often one of the most difficult problems in medicine. Dyspepsia, indigestion and stomach trouble are all common complaints; but the physician's task is to decide what they signify and what organic change underlies and produces them.

In general the questions to be answered are these: 1. Are the symptoms really due to disease of the stomach itself, or only to disturbed function produced by disease elsewhere? 2. If the disease is actually in the stomach, what is its character? According to the answer to these questions, cases fall into more or less well defined diagnostic groups; but to