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The phenomenon of peptic ulcer

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The American Journal of Digestive Diseases

Summay

The phenomenon of peptic ulcer is not a local one, and the importance of hyperacidity has been overemphasized. Peptic ulcer is an acute lesion which becomes chronic in most cases in two small circumscribed areas. If it would be only for acidity, ulcerations should be in all areas of acid secretion and mainly in the stomach. We have to think of a disturbance which first localizes and produces death of cells, like constant nerve activity in areas of endarteries; such a focus of irritation and inflammatory reaction may well produce the increased acid and night secretion in ulcer patients as a secondary effect. Studies on psychosomatic causation of hypersecretion and loss of mucus protection with consequent ulcer formation are just a few and without controls.

If anxiety is removed in psychiatric cases by lobotomy, anacidity or subacidity is changed into normo- or hyperacidity, but no ulcers have been observed (40). Concerning the constitutional ulcer type, there is quite a disagreement between Draper and Stenbuck on the ulcer nose (straight, and lack of prominence, versus thin long in the male and short wide in the female).

I have tried to build up an approach to the explanation of the ulcer phenomenon by using known facts and a few assumptions. It seems worthwhile, from time to time, to stimulate oneself and others by looking at theories from the other side, and to take stock of facts which are not considered sufficiently by an important group of workers. While it was not possible to go into all arguments and to review all known facts, this presentation may stimulate further critical discussion and further investigative work.

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Authors and Affiliations

  1. From the Department of Gastro-Intestinal Research, Medical Research Institute of Michael Reese Hospital, Chcago

    H. Necheles M.D., Ph.D., F.A.C.P.

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  1. H. Necheles M.D., Ph.D., F.A.C.P.
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Additional information

Papedr read on January 28, 1948. at the seminar of the Medical Research Institute of Michael Reese Hospital.

Aided by a grant from the A. B. Kuppenhelmer Fund.

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Necheles, H. The phenomenon of peptic ulcer. A. J. D. D. 16, 237–242 (1949). https://doi.org/10.1007/BF03005938

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