Massive Upper Digestive Tract Hemorrhage of Undetermined Origin

In a previous communication 1 one of us (I. R. J.) analyzed 60 cases of massive upper digestive tract hemorrhage of unexplained origin. Suggestions were made for earlier and more intensive studies of such patients in order to reduce the number of diagnoses of bleeding due to unknown causes, which at the Boston City Hospital was then as high as 9 per cent. Schiff 2 reported the incidence of such bleeding as 26.4 per cent; Thompson and associates, 3 2 per cent;Crohn, Marshak and Galinsky, 4 20 per cent, and Costello, 5 1.3 per cent. In accord with our previous suggestions, another group 6 at the Boston City Hospital recently has been intensively studying on admission patients bleeding from the digestive tract. Their report is that 5 per cent of the cases still remain unexplained. But when the frequency of hospital admissions for severe hemorrhage of the upper part