In the presidential address delivered before the American Surgical Association in 1900, Dr. Robert F. Weir 1 called attention to the surgical possibilities of ulcer in the duodenum. In his masterly presentation of the subject he dealt chiefly with the acute cases, especially those in which perforation had taken place. Within the following year the condition was recognized in examining patients in our clinic and several patients were operated on. The previous history in each case was so distinctive as to attract attention at once. Before the perforation occurred, the patients suffered from intermittent digestive disturbances followed by intervals, sometimes of great length, in which they were fairly well. The symptoms complained of were characteristic — hyperacidity, hypersecretion, hunger pain, food relief and, in the later stages, the phenomena which accompany obstruction. These various findings were most interesting and led promptly to a more careful examination in similar cases in