“DEADLY NIGHTSHADE” POISONING

emergency gastrectomy for perforated ulcer is still a comparatively rare procedure. In the case reported above, the perforation was so extensive that closure was impossible and there appeared to be no alternative to subtotal gastrectomy. As a general rule simple closure of the perforation is to be advocated, as rupture is a grave complication of peptic ulceration and the surgeon's primary consideration is to save his patient's life. However, in recent years both conservative treatment and radical resection have had their advocates. Hermon Taylor in 1946 reported a series of 28 cases of perforated ulcer treated conservatively with four deaths. His paper stimulated interest in the non-operative treatment of ruptured ulcer, and several small series have been reported since. In this connexion Professor Ian Aird (1949) writes as follows: