As long as the cause of peptic ulceration remains unknown, which unfortunately will probably be a long time, the methods used for its correction will vary and so will the results. This variation will depend on the knowledge and experience of the internist and the surgeon, and on the response of the patient to the method used to reduce gastrospasm by decreasing the quantity and concentration of hydrochloric acid secreted by the stomach. Variation also depends on the ability to develop the patient's insight and knowledge of the association of peptic ulcer with nervous and emotional disturbances. Of even greater importance is the response of the individual patient's gastrointestinal mucosa to the digestive action of gastric secretion. Only about 13% of the patients suffering from duodenal ulcer who have come to the Mayo Clinic in recent years have required surgical treatment. These patients had complications with which we are all
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Waltman Walters (1953) studied this question.
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