In this era, thinking about the problem of gastroduodenal ulcer genesis is likely to prove more profitable than investigation. The investigative work has been prolific for more than a century, and, if enthusiasm, expense, and man-hours spent are factors which bear on the success of research, it is fair to assume that the answer is already in, unrecognized as such, among the archives. It cannot be said, however, that the history of ulcer research has been marked by especially productive synthesis of the great mass of clinical, pathologic, and pathophysiologic information which has turned up. Continuous review of available data in the light of new concepts is of paramount importance in ulcer research.
The following summarizes current understanding of the anatomy and physiology of the native arteriovenous shunt system of the gastroduodenum, the mechanism which controls mucosal blood flow, as they may pertain to the genesis of gastroduodenal ulcer. It