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THE TREATMENT OF MASSIVE HEMORRHAGE DUE TO PEPTIC ULCER

JOHN S. LA DUE, M.D.
JAMA. 1939;113(5):373-377. doi:10.1001/jama.1939.02800300003002.
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All patients with hematemesis and melena due to peptic ulcer admitted to the Long Island College Hospital are fed immediately and repeatedly. This treatment has been employed in all ward and in a majority of private cases during the last eighteen years.

The therapy was devised by Dr. Andresen1 in 1916. He first gave gelatin mixtures to patients recovering from a gastro-enterostomy with such favorable results that he decided to give the same mixture to patients with gastric hemorrhage.

Most clinicians advocate a period of fasting, the giving of fluids and transfusions when needed, and rest. Lenhartz2 in 1906 treated 146 cases of hemorrhage due to peptic ulcer by feeding eggs and milk immediately. The mortality was 2.14 per cent.

Carlson3 demonstrated that an empty stomach is one in which active peristalsis and secretion take place. After hemorrhage the stomach is empty or filled with blood, usually

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