Despite a tremendous amount of experimental, anatomic and clinical investigation, the problem of the pathogenesis of ulcer is not yet solved. A discussion of the various theories will not be attempted here. Only the general trend of thought will be indicated.
For many years ulcer was considered a local disease. It was thought that the original defect was produced by local causes such as vascular or traumatic lesions and that its chronic character was the result of the unrest and irritation inherent in the stomach. This theory still has many adherents, notably Aschoff.
A study of the recent literature, however, shows a tendency to consider ulcer a local consequence of a general bodily disturbance. For instance, von Bergmann1 and his pupils, Westphal and Katsch,2 following Eppinger and Hess, have found general "vagotonic" stigmas in ulcer patients. Friedman3 has added a "sympathicotonic" group. Peritz and Fleischer4 describe a "spasmophilia" of the
WINKELSTEIN A. GASTRIC AND DUODENAL ULCER: THEORETICAL AND CLINICAL STUDIES. Arch Intern Med (Chic). 1926;37(4):541–549. doi:10.1001/archinte.1926.00120220091005
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