To the Editor.—As one of those who for years has beat the distant drum of emergency endoscopy in massive gastrointestinal tract bleeding, it was with surprise and pleasure that I read "Massive Gastrointestinal Bleeding: A Panel by Correspondence" by Dunphy et al (Arch Surg 107:367-372, 1973). From Silen's, "endoscopy is now becoming the most useful single diagnostic step"; through Moody's, "fiberendoscopy of the esophagus, stomach, and duodenum is the most single [sic] valuable step"; and Mikkelsen's, "Once again, endoscopy becomes the key to diagnosis"; to Dunphy's concluding, "we have been brought up to date... particularly on the new and important roles of fiberoptic endoscopy in upper gastrointestinal tract bleeding"; the panelists appear to believe they are calling attention to an important innovation. Important, yes; but new?
Following long after Eddy Palmer's pioneering work,1 in 1966 we reported a series of 323 cases seen at the Massachusetts General Hospital