Few real surgical emergencies remain, but perforation of a peptic ulcer must be classed as one of the conditions demanding immediate surgical therapy. Much has been written on this subject, but there would seem to be a place for a more fundamental approach toward the bacteriologic and chemical problems involved. Perusal of the literature reveals a predominance of papers dealing with statistics or with points of technic rather than planned studies. It is the purpose of this paper to present data obtained from observations on a number of patients with benign ulcers of the stomach or the duodenum with free perforation into the general peritoneal cavity. I exclude from this group all malignant ulcers with perforation or posterior benign ulcers which have perforated into the lesser peritoneal cavity.
There is fairly general agreement1 that intra-abdominal infection is a major cause of death in cases of gastric and duodenal perforations,