Evening star. [volume] (Washington, D.C.) 1854-1972, 1930-08-08
Duodenal Ulcer.

A large metropolitan clinic or clique
Of doctors reports Ito the profession)
that permanent cure is obtained in
less than so per cent Of cases Of duo
denial ulcer by operation, and that
secondary gastro-jeiunal liberation
chat means q new ulcer ut the site
Of the short-circuit union of stomach
and intestine below the site of the
duodenal ulcer) occurs In a third OF
the cases operated upon.
Not so good, considering the claims
many perfectly def operators make for
surgical treatment as against medical
treatment: yet not so bad, considering
the fact that in some of the surgical
cases the operation Is done as an
emergency measure or even as a last
resort after medical treatment has
proved inadequate or neglect has
brought the patient to q grave condi-
ton.
These data may be taken as an i'm
partial, honest index of the effective
ness OF surgery In peptic ulcer.
Equally fair data on the effective
ness Of medical treatment indicate that
in actual practice approximately so
per cent OF cases Of duodenal ulcer g
out of 10 cases OF pepsic ulcer are duo
denaD are permanently cured. My
personal belief Is that by the intelli-
gent application of our newer knowl-
edge Of nutrition and therapeutics the
effectiveness Of ordinary medical treat
ment of ulcer will be considerably in
creased, so that from now on such
cases will remain medical cases until
some complication or emergency makes
them surgical cases or until a careful
course of medical treatment fails tc
give satisfaction.
AS it Is none Of the patients business
what these complications or emergency
conditions may be that call for surg
ical Intervention, we. shall pass over
them here, except to say that the pa
tent had better leave all such worry
ing TO his doctor.
BY the way, any one who may be
trying to decide whether to have med
ical or surgical treatment for peptie
ulcer should first make sure he has
an ulcer. The joke is not so much
on the doctor if he makes a mistake
in diagnosis, nor on the surgeon If he
concludes to call his work exploratory
The joke is very much on the patient
if his trouble happens to be just a
duodenal ulcer complex due to excessive
use OF tobacco. One luckleSS sufferer
tried various KINDS of treatment for
ulcer for 25 years, then learned that
he had no ulcer, but a chronic chole-
cystitis (gall-bladder trouble). In not
q few cases recurring appendicitis has
masqueraded as duodenal ulcer Now
adays the X-ray pictures, following
barium test meal, help considerably In
the diagnosis. though the opinion OF
the physician who has studied the case
is at least as weighty in the final de-
cision as any X-ray evidence can be
and any one who pins faith to unsup-
ported X-ray evidence lays himself
open to serious error, whether he sub
Inits to operation or not. X-ray
examination with the aid of the bariun
meal (barium serves simply to outline
the stomach and intestine in the mega.
tive) Is of great value in checking the
progress Of the case under medica
treatment, and such check is nov
made regularly at six-month intervals
by doctors who give peptic ulcer casei
careful and successful treatment.
(CopyriKht, 1901