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Article
October 30, 1915

THE ESSENTIAL FACTORS IN THE DIAGNOSIS OF CHRONIC GASTRIC AND DUODENAL ULCERS

Author Affiliations

ROCHESTER, MINN.

From the Mayo Clinic.

JAMA. 1915;LXV(18):1500-1503. doi:10.1001/jama.1915.02580180004002
Abstract

This review is undertaken to emphasize proved clinical factors and briefly to consider various phases of experimental, clinical and therapeutic advancement in their application to the diagnosis of benign, chronic gastric and duodenal ulcers. Our observations are based on the study of 2,400 cases of gastric and duodenal ulcers operatively demonstrated in the Mayo Clinic from 1900 to 1914, inclusive, with an especial summary of the cases of 1913 and 1914.

DIAGNOSIS  A skilful anamnesis, in the absence of extensive clinical observations or direct roentgenologic evidence of a lesion, is still the most important factor in the differential diagnosis of lesions causing gastric disturbance. With regard to ulcer, characteristic chronicity or remission of symptoms is readily apparent in the case records in over 80 per cent, of all our proved cases. The principles emphasized by Graham1 since his earliest observations are as effective today as then and are the

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