I cannot altogether agree with those who think that, as regards the frequency of gastric ulcer, it is much more often suspected when it does not exist, than overlooked when actually present. But all are agreed as to the rarity of duodenal ulcers. Of this latter, it is doubtful if more than 70 authenticated cases are on record; while gastric ulcers, either cicatrized or open, are found in about 5 per cent, of persons dying from all causes. It may be very difficult to decide whether an ulcer which is believed to exist is gastric or duodenal in position. And this fact, coupled with the frequency of these ulcers, their dangerous character, and the great importance of proper treatment, leads me to report to you some recent cases.
It is true that you can diagnose gastric ulcer with confidence in cases attended with characteristic paroxysmal circumscribed epigastric pains extending through
PEPPER W. DUODENAL AND GASTRIC ULCERS. A Clinical Lecture delivered at the Hospital of the University of Pennsylvania. JAMA. 1889;XII(21):721–725. doi:10.1001/jama.1889.02400980001001
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