Indigestion and heartburn have been described for thousands of years, but i
t was only in the 16th century that the disease peptic ulcer was establishe
d by autopsy. At first only gastric ulcers were identified. In the 18th cen
tury, duodenal ulcers, most of which were fatal cases after perforation or
hemorrhage, were seen. In the 19th century, when autopsy became a common, e
ven routine, hospital procedure, uncomplicated acute and chronic ulcers wer
e found and then correlated. with symptoms. Thus, our current clinical unde
rstanding dates from the 1820s, by which time peptic ulcers were being repo
rted in the U.S. It is unclear why gastric ulcers were not diagnosed at The
Mount Sinai Hospital until 1873 and duodenal ulcers until 1885. However, a
fter that time both conditions were diagnosed frequently and they rapidly b
ecame common and were treated medically and surgically.