CHANGES PRODUCED BY VARIOUS OPERATIONS ON THE STOMACH

Posterior gastro-enterostomy performed in properly selected cases has long been accepted as one of the most satisfactory procedures in the treatment of duodenal ulcer. Two reasons have generally been advanced in explanation of its efficacy. First, it has been stated that the formation of a gastro-enterostomy stoma allows the gastric contents to pass into the jejunum without going through the duodenum, thereby removing the irritation of acid and food and allowing the ulcer to heal. Roentgenologists have taught, however, that in most patients unless the pylorus is completely obstructed the gastric contents leave the stomach to a large degree not through the gastro-enterostomy stoma but through the pylorus; and in spite of the fact that the ulcer continues to be exposed to the irritation of gastric contents, though perhaps for not so long a time, it usually proceeds to heal. The second explanation which has been offered is that gastro-enterostomy