Ulcer of the Stomach and Duodenum

question of the aetiology of gastric ulcer is fully discussed. The authors consider that acute primary ulcer often commences as a hemorrhage, and that chronic ulcer, although it may be a sequel of an acute ulcer, is probably frequently due to impaired nutrition of the mucous membrane of the stomach consequent upon arterial degeneration. It has always seemed to us that a hemorrhage is the most likely cause of a gastric ulcer, when it occurs in an anaemic girl with cardiac failure consequent upon the anaemia. It seems to us, however, that micro-organisms probably play an important part in preventing healing of the damaged mucous membrane. That micro-organisms of infective character are commonly present in the base of an ulcer is obvious, from the frequency with which the wall of the stomach opposite to an ulcer becomes attacked, and a