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Related post: Gastric Buy Tofranil and Duodenal Ulcer."* The sub-
ject was introduced by Dr. Arthur Dean
Bevan, of Chicago, with a paper entitled
the "Relative Value of Surgical and Med-
ical Treatment of Gastric and Duodenal
Ulcer." He made a comparison of gastric
and duodenal ulcer with varicose ulcers,
stating that if both were given rest, in
uncomplicated cases, the majority Tofranil Tablets would
heal without operation, but that Order Tofranil Online those
with complications would require surgical
treatment. In his summary Dr. Bevan
"To visualize this a little more clearly, let us Tofranil Mg
take 100 cases of peptic ulcer. Practically all
of these should be given at first the benefit of
sound medical management. Possibly ninety of
these patients may be cured and kept well by
*Bevan, Arthur D.: Relative Value of Surgical
and Medical Treatment of Gastric and Duodenal
Ulcer. J. A. M. A., Vol. 79, No. 1, July 1, 1922.
Sippy, Bertram W.: Ibid.
Brown, Thomas R.: Ibid. Discussion by Drs.
Finney, White, Alvarez, Ochsner, Smithies, Cof-
fey, Harris, Horsley, Bevan, Mayo, Sippy and
Brown. โ€” Ibid.
medical management. Probably 10 per cent of
these cases, after repeated Tofranil Online trials of medical man-
agement, will prove refractory and should then
be given the benefit of exploratory operation and
surgical therapy."
Dr. Bertram W. Sippy, of Chicago, fol-
lowed with a paper on "Relative Value of
Medical and Surgical Treatment of Gas-
tric and Duodenal Ulcer." Dr. Sippy dis-
cussed the question Order Tofranil from the medical
viewpoint. In part he said:
"The relative value of medical and surgical
treatment of peptic ulcer and the Tofranil 50 Mg indications for Buy Cheap Tofranil
each are dependent upon a number of factors.
Among these, three stand foremost. The first
factor" has to do with the conditions and compli-
cations that attend the ulcer. The second in-
volves a careful consideration of the character
of the surgical treatment to which the patient is
to be subjected. Herein the skill of the surgeon
who is to perform the operation is of the utmost
importance, since it influences enormously the
immediate mortality and, to a lesser degree, the
late bad effects of the operative treatment of the
disease. The third pertains to the straightfor-
wardness with which the type of medical treat-
ment employed combats or removes the condi-
tions that retard or prevent healing and thus
contributes to the eradication of the ulcer and its
Dr. Sippy's conclusions were that med-
ical treatment will cure the great majority
of cases of ulcer and that surgery should
not be Generic Tofranil resorted to until a thorough effort
at medical treatment has been made.
Dr. W. J. Mayo's paper, entitled "Prog-
ress in the Handling of Chronic Peptic
Ulcer," was read by Dr. Charles Mayo,
who among other things said :
"Each case must be considered individually, and
when it is reasonably possible, careful medical
management of the ulcer should be given a thor-
ough trial before operation is recommended.
Following operation, the after-care of the pa-
tient should be conducted by the internist. Pos-
sibly educational propaganda may be instituted
for the benefit of the patient with peptic ulcer,
as has been done for the patient with diabetes."
In speaking of Tofranil Uses failure to cure in opera-
tions for ulcer, Dr. Mayo said :
"To express it in the form of an Hibernicism,
the most frequent cause of surgical failure in
such cases is to operate for peptic ulcer when
there is no ulcer. At the Mayo Clinic we have
removed several hundred Tofranil Pm unnecessary gastro-
enterostomies that had been made in good faith
and bad judgment; fourteen of them were our
own early cases."
Mayo's conclusions were as follows:
(1) Duodenal Tofranil Cost ulcer is treated satisfactorily by
surgery in approximately 95 per cent of cases,
August 1922
although in 1 or 2 per cent of these a second
operation may be required. The ulcer is not as-
sociated with cancer liability.
(2) The average operative mortality in cases
of duodenal ulcer, including the acute and
chronic cases, is under 2 per cent from all
3; and. as the part of the duodenum usu-
ally involved is merely the vestibule of the small
intestine, permanent interference with function
is slight.
(3) In cases of gastric ulcer, satisfactory re-
sults are obtained by one operation in more than
85 per cent. In the remaining cases, a second-
ary operation, preferably resection Purchase Tofranil which elim-
inates to a great extent future ulcer possibilities,
brings the surgically satisfactory group of gas-
tric ulcers well above 90 per cent; but there is a
definite cancer liability in the years to follow.
(4) The average mortality in the operative
treatment of cases of gastric ulcer, including the
acute and chronic cases, is about 3.5 per cent.
The Tofranil Price stomach has important functions to per-
form and a certain amount of permanent crip-
pling may result.
(5) In about 50 per cent of Buy Tofranil Online the patients who
fail to obtain satisfactory relief, the difficulty is
functional and can be relieved by medical man-
agement. Purchase Tofranil Online The other 50 per cent must be classi-
fied as Cheap Tofranil surgical failures due to faulty mechanics
and will require secondary corrective surgical
procedures for relief.

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