BLEEDING PEPTIC ULCER

To the Editor:—  This note refers to an article in The Journal, June 26, 1954, page 833, entitled "Bleeding Peptic Ulcer Complicating Hydralazine and Hexamethonium Bromide Therapy," by Mandelbaum, Brook, and Mandelbaum. In this article bleeding from a duodenal ulcer developed in the patient, who was markedly hypertensive, following therapy with hydralazine and hexamethonium. This complication simulates the occasional experience observed after surgical sympathectomy. Wilkins speculated that autonomic sympathetic blockade might allow unopposed hyperacidity to become exaggerated and precipitate hemorrhage from a peptic ulcer.I have observed a patient who has had hypertension for many years, ranging around 210/120 mm. Hg. He had never had the drugs above mentioned but was taking rauwolfia preparations for about a year. In the early part of the year he had been taking alseroxylon (Rauwiloid), 4 mg. per day, and about two months prior to the incident to be discussed he had received Raudixin