Causes and treatment of peptic ulcer
- 15 Downloads
Summary and Conclusions
1. An attempt is made, by following the ancient classifications, to analyze and evaluate the various causes of peptic ulcer.
2. The material cause—the biological structure of the tissue—may still be considered an uncontrollable factor.
3. The occasional cause — changes in the tissues arising from trauma or circulatory disturbances—are important, but it is doubtful whether they can start an ulcer in the absence of abnormal acidity.
4. The formal cause—the shape of the stomach and the mechanism of the pyloric sphincter—is treated by various types of surgical operations which do not obtain an absolute percentage of good results because they act only indirectly on the efficient cause (secretion of acid) and do nothing for the main or final cause.
5. The efficient cause — hyperacidity — is counteracted by our dietetic prescriptions, but the results are often incomplete because this therapy also does not affect the final cause. Attention is called to the “bad timing” of the acid secretion as an essential feature and to the appearance of prolonged acid crises. Emphasis is laid on the neurogenic theory.
6. The final causes are discussed and a possible line of treatment is suggested regarding the regulation of mental activities in such a way as to protect the local mechanism of digestion against the inroads of the central nervous system.
KeywordsPeptic Ulcer Duodenal Ulcer Gastric Ulcer Intestinal Motility Circulatory Disturbance
Unable to display preview. Download preview PDF.
- 1.Spira, J. J.: The Causation of Gastro-duodenal Ulcers. London, Oxford University Press, 1931.Google Scholar
- 2.Rehfuss, M. E.: The Diagnosis and Treatment of Diseases of the Stomach. Philadelphia, W. B. Saunders Co., p. 577, 1927.Google Scholar
- 3.Oshsner, A., Gage, M. and Hosoi, K.: The Treatment of Peptic Ulcer Based on Physiologic Principles.S. G. O., 62:257, Feb. 15, 1936.Google Scholar
- 4.Weiss, A. and Aron, E.: Rôles des Acides Aminés Dans l’évolution de l’ulcère Experimental. Influence de l’histidine.Presse Med., 41, 2:1880, Nov. 22, 1933.Google Scholar
- 5.Aschoff, L.: The Relations of Mucosal Erosions to the Development of Ulcer of the Stomach. Lectures on Pathology, p. 279. New York, P. B. Hoeber, 1924.Google Scholar
- 6.Virchow, R.: Simple Chronic Gastritis.Virchows Archiv., 5:362, 1853.Google Scholar
- 7.Hurst, A. F. and Stewart, M. J.: Gastric and Duodenal Ulcer. London, Oxford University Press, 1929.Google Scholar
- 8.Bodlyreff, W.: The Self-Regulation of the Acidity of Gastric Contents and the Real Acidity of the Gastric Juice.Quart. J. Exper. Physiol., 8:1, 1914.Google Scholar
- 10.Cushing, H.: Peptic Ulcers and the Interbrain.S. G. O., 55:1, July, 1932.Google Scholar
- 11.Von Bergmann, G.: Ulcus Duodeni und Vegetatives Nerven-System.Berliner klin. Wchnschr., 50 (2): 2374, 1913.Google Scholar
- 12.Eppinger, H. and Hess, L.: Vagotonia. New York, The Nervous and Mental Diseases Publishing Co., 1915.Google Scholar
- 13.Goetze, Otto: Handbuch der praktischen Chirurgie. Vol. III:270. Stuttgart. Fred Enke, 1929.Google Scholar
- 15.Von Bergmann, G.: Das Spasmogene Ulcus Pepticum.Munchen med. Wchnschr., 60 (I):169, Jan. 28, 1913.Google Scholar
- 16.Eusterman, G. B. and Balfour, D. C.: The Stomach and Duodenum. Philadelphia, W. B. Saunders Co., 1935.Google Scholar
- 17.Rivers, A. B. and Dry, T. J.: A Rationale for the Treatment of Peptic Ulcer.Amer. Jour. Digest. Dis. and Nutrit., Vol. I:522–526, Sept., 1934.Google Scholar