The diagnosis of gastric and duodenal ulcer is not made so frequently now as it was ten or eight or even six years ago. In 1912, for instance, the total number of patients seen for diagnosis, all of them with medical ailments and a large proportion complaining of "stomach trouble," amounted to 445; and among these a diagnosis of ulcer, gastric or duodenal, was made in twenty-eight. In 1918, with a total of 461 cases, the diagnosis of ulcer was made only ten times. The main reason for this decrease lies in the more rigid tests gradually adopted, and the attempt to substitute demonstration for inference, before a conclusion is reached.
The data on which the diagnosis of ulcer depended only a few years ago were obtained from history, physical examination and analysis of gastric contents.
IMPORTANCE OF THE HISTORY OF THE CASE
The history was considered of special importance