MEDICAL JOURNAL 781crash into our textbooks of physiology and of information theory. But most thinking neurologists look askance at all cerebral diagram-makers and cartographers, whether they tell of cortical architectonics, motor homunculi, suppressor bands, or linguistic schemata. Mindful of the fate of phrenology, modern neurology has but little respect for cerebral mosaics. How then should we judge Gall to-day, after we have divorced the accomplishments of the man from the record of his phrenological votaries? Gall represents a "great though misguided, and perhaps even slightly ridiculous, figure in the rise of a progressive science." This, according to Temkin, was the verdict of the historians of philosophy, Littr6 and Leaves. Perhaps they were a little too hard. To contemporary neurologists Gall was a great man.May I, in conclusion, quote that inspiring anatomist, the mentor of so many of us older medical scientists? " The time has come," he wrote, " for a juster appreciation of the important part played by Gall, and a more adequate recognition of his achievements than has been made in the past. If he was responsible for certain speculations, which in the hands of irresponsible followers have been used for meretricious purposes, it must not be forgotten that Gall's work brought to an end a barren system of philosophy which seriously impeded progress. His contributions to the anatomy of the central nervous system are of far-reaching importance, and to the physiology of the brain and to psychological theory he gave a new orientation and a new inspiration." These were the words of Elliot Grafton Smith, with which you and I might perhaps agree.Bleeding Peptic UlcerBrit. med. J'., 1965, 2,[781][782][783][784] In the past 30 years few conditions have provoked wider divergence of opinion upon treatment than bleeding from peptic ulcer. Before the last war the tendency was to follow the practice of Meulengracht (1935) and to treat this condition conservatively. However, some surgeons, notably Finsterer, were reporting good results from the early employment of surgical treatment. In the years that followed the war certain indications for surgical treatment came to be fairly generally accepted (Gordon-Taylor, 1946 We have for some years accepted the usual criteria for intervention-that is to say, severe repeated or continuous bleeding-but have, as a result of experience over 10 years or so, learned to regard the chronicity or otherwise of the ulcer as irrelevant and have adapted the surgical procedure to the condition found at operation. In the past five years 223 patients with haematemesis and melaena thought to be due to peptic ulceration have been treated, and in this paper the results of treatment are analysed.
Material and ManagementAll of the patients in this series were admitted to hospital in one five-year period, and are those in whom there was direct evidence of haematemesis or melaena, sufficient to cause a moderate-to-severe fall in haemoglobin at some time, either immediately before or after admission. ...
