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JAMA. 1915;LXV(15):1227-1231. doi:10.1001/jama.1915.02580150001001.
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This paper is presented to call attention to three propositions: I. Gastric cancer originates from gastric ulcer much more often than was formerly believed. II. We have no diagnostic methods to tell us positively when a chronic gastric ulcer has become malignant, until the change is far advanced. III. Surgical treatment should be recommended for gastric ulcer more frequently in the future and with less delay.

I. ORIGIN OF GASTRIC CANCER  The literature of this subject goes back to Cruveilhier,1 who first segregated simple chronic ulcer of the stomach from chronic gastritis on the one hand and cancer on the other; and whose observations and descriptions were so complete that gastric ulcer is still referred to in French literature as "Cruveilhier's disease." Even at the early date at which he wrote, 1829 to 1835, he noted the coexistence, at times, of ulcer and cancer and the possible relation of


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