On perforative ulcers of the stomach and duodenum

Diagnosis of perforative ulcers of the stomach and duodenum in typical, trivial cases, delivered at an early stage, is relatively easy: The ulcerous history, the sudden pain of an acute, twitching nature, mainly in the epigastrii, the sharply pronounced tension of the abdominal muscles,-mainly the rectus muscle on the right side, with the absence of breathing movements of the abdominal muscles (Breehe), all this gives an extremely typical picture, allowing a diagnosis of perforation to be made with certainty. This very picture was expressed in two of our patients, one of whom was in the clinic, was preparing for surgery for a gastric ulcer with a verified diagnosis and gave a picture of perforation the day before surgery; the other patient was in the Therapeutic Clinic with a diagnosis of ulcer and during the probe examination he felt sharp pain in the right abdomen, after which he had a plank-like muscle tension.