Age. 1-10. 10-20. 20-30. 30-40. 40-50. 50-60. 60-70. 70-80. 80-90. 90-100. Over 100.
No. of cases. 1 32 119 107 114 108 84 35 6 ... 1
Totals. 33 226 222 119 7

From this table it is apparent that three-fourths of the cases are found between the ages of twenty and sixty, and that the cases are distributed with tolerable uniformity between these four decades. The largest number of cases is found between twenty and thirty. The frequency of gastric ulcer after sixty years diminishes, although it remains quite considerable, especially in view of the comparatively small number of those living after that period.

14 The sources of these statistics are the same as those of the statistics relating to sex in the preceding foot-note. The age in the Erlangen cases of open ulcer is given by Hauser (Das chronische Magengeschwür, p. 191, Leipzig, 1883). It is evident that only about two-fifths of the cases could be utilized, partly because in some the age was not stated, but mainly on account of the necessity of excluding scars—a self-evident precaution which Brinton did not take.

The probability that many cases of ulcer included in the above table existed for several years before death makes it desirable that estimates as to the occurrence of the disease at different ages should be made also from cases carefully diagnosed during life, although the diagnosis must necessarily be less certain than that in the post-mortem records. The best statistics of this character which we possess are those of Lebert, from whose work the following table has been compiled:

Age in 252 Cases of Gastric Ulcer diagnosed during Life by Lebert.15

Age. 5-10. 11-20. 21-30. 31-40. 41-50. 51-60. 61-70.
No. of cases. 1 24 87 84 34 17 5
Totals. 25 171 51 5
Per cent. 9.92 67.85 20.24 1.99

Of these cases, nearly seven-tenths were between twenty and forty years of age—a preponderance sufficiently great to be of diagnostic value.16

15 Op. cit., p. 199. Of these cases, 19 were fatal, and the diagnosis was confirmed after death. All of the cases were studied by Lebert in hospitals in Zurich and Breslau.

16 In my opinion, clinical experience is more valuable than are post-mortem records in determining the age at which gastric ulcer most frequently develops. In support of this opinion are the following facts: In many cases no positive conclusions as to the age of the ulcer can be drawn from the post-mortem appearances, and sufficient clinical history is often wanting; a considerable proportion of the cases of gastric ulcer do not terminate fatally with the first attack, but are subject to relapses which may prove fatal in advanced life; in most general hospitals the number of patients in advanced life is relatively in excess of those in youth and middle age. By his faulty method of investigating this question, Brinton came to the erroneous conclusion that the liability to gastric ulcer is greatest in old age—a conclusion which is opposed to clinical experience.

The oldest case on record is the one mentioned by Eppinger,17 of an old beggar whose age is stated at one hundred and twenty years.