Medical Aspects of Chronic Ulcerative

CHRONIC ulcerative colitis continues to present difficult problems to the physician. Although our ability to relieve symptoms and induce remissions has improved dramatically within the last few years, our basic unders tanding of the etiology and pathogenesis of the disease has advanced little since its original description dur ing the Civil War. Recent studies 1-3,7 have demonstrated conclusively the existence of auto-antibodies in human beings with ulcerative colitis whereby specific immune mechanisms operate against colonic mucosa. Although specificity of these antibodies is not absolutely conclusive, their overwhehning preponderance in patients with active ulcerative colitis is highly significant. Whether this is simply an accompaniment of the pathologic process or whether it is of significant etiologic or pathogenetic significance remains to be demonstrated. Taylor and TrueloveS, 9 recently re-emphasized an old, a l though by no means universally accepted, observation that allergy to milk has been noted in an appreciable number of patients with chronic ulcerative colitis. Objective demonstrat ion of antibodies to milk was included in his report. Continuing isolated instances of apparent ly idiopathic chronic ulcerative colitis occurring in the wake of chronic amebic infestation, bacillary dysentery, and more recently, the acute enterocotitis resulting from administration of antibiotic agents attest to the nonspecificity of the ir~citing agent in chronic ulcerative coiitis.