Based on the reasoning that the incompleteness in the treatment of gastric ulcer reported previously is based on the vagueness of the decision of therapeutic principle and the general rule that the treatment of gastric ulcer should be medical, a brief trial of rigid medical management was examined as the starting point.
1. The object is the diagnosis through treatment to differentiate between benign and malignant lesions and between those which respond readily to treatment and those which do not.
2. Using the Bockus-Paustian's original method as the reference, 2 weeks of non-irritating fluid diet such as milk, rice soup, juice, soup and bean-curds were prescribed.
3. Changes in the result of general clinical tests before and after this treatment were not remarkable except for elevation of gastric ulcer.
4. In 34 cases or 60%, reaction to treatment was favorable with decrease in the size of the ulcer, while no decrease in size was noted in 23 cases or 40%. However, it is difficult to predict the results of therapy from the clinical findings before treatment.
5. In patients who responded favorable to treatment, the subsequent course was good, resulting in the rate of healing of 82% after 1-3 years of following up period. In those who responded poorly to treatment, only 15% reacted the state of cure, showing a distinct difference.
6. No decrease in size was seen in malignant ulcer.
As a method of diagnosis through treatment, this brief trial of rigid medical management seems to be reasonable.
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