PAIN IN THE PERFORATING TYPE OF PEPTIC ULCER

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Abstract
This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables. Moynihan once said that peptic ulcer could be diagnosed over the telephone. He pointed out that duodenal ulcer is likely to produce the typical "food-comfort-pain" picture whereas gastric ulcer is more prone to cause the typical "food-comfort-pain-comfort" syndrome. All physicians are familiar with the classic picture of recurrent episodes of epigastric burning, gnawing or hunger distress which begin from half an hour to several hours after meals and are eased by food or soda. The telephonic diagnosis of peptic ulcer would go far amiss if it should be employed in cases of complicated peptic ulcer. Although it is true that uncomplicated peptic lesions involving stomach, duodenum or anastomatic stoma follow the usually accepted pattern so well described by Moynihan, it is equally true that the more serious the complication the less stereotyped and clocklike are the symptoms caused by such lesions. Change from the accepted pattern is particularly true of

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