THE HISTORY OF GASTRIC SURGERY

The history of gastric surgery is one of the most complex in the annals of medicine. The practice of this surgery depended upon the growing know-ledge of the pathology of gastric diseases. This knowledge, together with animal experiments and the introduction of anaesthesia during the last century, led to the first successful planned opera-tion for a disease of the stomach. The last 20 years of the nineteenth century saw the intro-duction of many gastric operations, some of which were to become established and modified during the ensuing years. In the writings of Celsus14 in the first century and Galen29 in the second century, vague re-ferences were made to ulcers of the stomach, but it was not until the revival of medicine in the sixteenth century, with its attendant increase in post-mortem examinations, that further examples were recorded. In 1596 Marcellus Donatus2l described the autopsy on a man of 59 years, who was found to have a gastric ulcer. Littre46 reported, from thediary of a Lady-in-Waiting to Henrietta Anne, Duchess of Orleans and daughter of King Charles I of England, how the Duchess had died, in I670, from a perforated gastric ulcer, following years ofdyspepsia. The writings of John Bauhin in the Sepulchretum of Boneti'0 in I679 give a fulldescription of a physician's wife, aged I9, who died from a perforated gastric ulcer. The first accurate and extensive description of gastric ulcers and cancer is attributed to Mathew Baillie in I7932. Duodenal ulceration was not recognized until the early part of the nineteenth century when Benjamin Travers76 reported on two cases which had died of perforations. This was followed by an excellent description by Joh