17 Prager Vierteljahrschrift, Bd. 116.

The occurrence of simple ulcer of the stomach under ten years of age is extremely rare. Rokitansky, with his enormous experience, said that he had never seen a case under fourteen years.18 There are recorded, however, a number of cases of gastric ulcer in infancy and childhood, but there is doubt as to how many of these are genuine examples of simple ulcer. Rehn in 1874 analyzed a number, although by no means all, of the reputed cases, and found only six, or at the most seven, which would stand criticism.19 The age in these seven cases varied between seven days and thirteen years. In one case (Donné) a cicatrix was found in the stomach of a child three years old. Since the publication of Rehn's article at least four apparently genuine cases have been reported—namely, one by Reimer in a child three and a half years old; one by Goodhart in an infant thirty hours after birth; one by Eröss in a girl twelve years old suffering from acute miliary tuberculosis, in whom the ulcer perforated into the omental sac; and one by Malinowski in a girl ten years of age.20

18 Communication to Von Gunz in Jahrbuch d. Kinderheilkunde, Bd. 5, p. 161, 1862.

19 Jahrb. d. Kinderheilk., N. F., Bd. 7, p. 19, 1874.

20 Reimer, ibid., Bd. x. p. 289, 1876; Goodhart, Trans. London Path. Soc., vol. xxxii. p. 79, 1881; Eröss, Jahrb. f. Kinderheilk., Bd. xix. p. 331, 1883; Malinowski, Index Medicus, vol. v. p. 575, New York, 1883.

Rehn does not mention Buzzard's case of perforating ulcer in a girl nine years old (Trans. London Path. Soc., vol. xii. p. 84, 1861). See also Chvostek's case of round ulcer in a boy (Arch. f. Kinderheilk., 1881-82) and Wertheimber's case of recovery from gastric ulcer in a girl ten years old (Jahrb. f. Kinderheilk., Bd. xix. p. 79).

The mean age at which gastric ulcer develops is somewhat higher in the male than in the female. This is apparent from the following collection of 332 cases of open ulcer in which both age and sex are given:21

Age.10-20.20-30.30-40.40-50.50-60.60-70.70-80.80-90.90-100.Over 100.Total.
Males.9334439372051...1189
Females.1335252518189.........143

In males the largest number of cases is found between thirty and forty years, and in females between twenty and thirty. In males 54½ per cent. of the cases occur after forty years of age, and in females 48.9 per cent.

21 These cases are obtained from the same sources as those of the first table (page [483]).