The problem of chronic gastric and duodenal ulceration merits most serious consideration since it is apparent that there still exist, in respect to significant aspects of the disease, rather striking differences of opinion. These, I believe, are due in part to incomplete knowledge and in part to the fact that the significance of certain established principles has not been fully understood. Convincing information is lacking as to the incidence of ulcer; its cause is complex, and the great variations in the manifestations and complications of the disease emphasize the incompleteness of knowledge of the subject. Lack of knowledge, however, contributes less to the difficulties than do erroneous interpretations of results of treatment, failure to distinguish between gastric ulcer and duodenal ulcer and, lastly, the failure fully to comprehend the importance of the fact that the normal tendency of chronic peptic ulcer is to recur.
This tendency to recurrence, although characteristic