Chronic ulcerative colitis remains an enigma despite many years of study and voluminous publications by persons of diverse interests and backgrounds. Its etiology remains unknown and its treatment unscientific. The innate variability of the disease with its tendency to spontaneous remissions and exacerbations render it extremely difficult to study by well-designed tests or with controlled clinical trials. Even in the evaluation of the effectiveness of a single drug, such as an antibiotic or an adrenal steroid, with few exceptions, published studies have seldom been well designed or accompanied by adequate controls. In part, this has been due to inadequacies in the experimental design but in a large measure it has also been due to the inherent difficulties of studying a disease of great variability and unpredictability. The problems in evaluating the efficacy of drug therapy in ulcerative colitis are as nothing compared to those arising when one tries to evaluate
Lepore MJ. The Importance of Emotional Disturbances in Chronic Ulcerative Colitis. JAMA. 1965;191(10):819–824. doi:10.1001/jama.1965.03080100037009
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