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SECRETORY MANIFESTATIONS OF GASTRIC ULCER

JAMA. 1923;81(23):1954. doi:10.1001/jama.1923.02650230038014.
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The importance of accurate methods of examination applied to the problems of diagnosis and therapy has been well exemplified of late with regard to gastric ulcer, a subject in connection with which conjecture has vied with the scheme of trial and error to secure desired ends. Thus, hyperacidity has been described as a "classical symptom" of ulcer of the stomach;1 and, consequently, the practitioner is taught that "the acid secretion should be reduced as a first step by regimen, diet and remedies,"2 the latter being interpreted as alkalis. If one accepts Carlson's 3 judgment that "there is no disease known capable of inducing true gastric hyperacidity," and that "the pathologic deviations in acid and pepsin concentrations are invariably in the direction of decrease," the claim of hyperacidity can at best represent only hypersecretion, which has, in fact, been found to occur in some cases of demonstrable gastric ulcer.

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