Freezing duodenal ulcer dangerous, doctors told

              A Kansas City gastroenter-ologist warned here Monday that freezing of duodenal ulcers can prove both dangerous and fatal.
Dr. Arthur P. Klotz of Kan-City said he realizes this
a controversial issue and that some physicians will not with him.
''But after carrying on ex­periments with 300 volunteer pa­tients over a six months peri­od, I would certainly advocate discontinuance of this method of treatment," he said. "Not only could it prove dangerous, but the good it accomplishes is only temporary."
Dr. Klotz was a featured speaker at the 27th annual meet­ing of the N. 0. Graduate Medi­cal Assembly, which opened Monday at the Roosevelt Hotel.
Interviewed between assem­bly sessions, the physician said! he    believes   the   enthusiasm!
Cont. in Sec. 1, Page 37^CoT~li
w h i c h initially greeted ulcer freezing is dying down.
"X think we should go back to the usual method of med­ical   management   in   which anti-acids are combined with acid-suppressing   drugs,"   he added. "If such a program of treatment is followed proper­ly, almost 100 per cent of the patients will be entirely pain-free and, in a short time, the ulcer will be completely heal­ed without surgery." Dr. Klotz said each one of th< 300 volunteers went through th( standard 45 minutes of freez< ing.
"Each one swallowed an un-inflated stomach-shaped balloon to which rubber tubing was at­tached. The other end of the tubing was hitched up to the freezing machine which cir­culated 700 to 900 cubic centi­meters of cooling fluicj from the balloon back to the machine and from machine back to the bal­loon."
17 BELOW ZERO
Dr. Klotz said temperature of the fluid, going back into the balloon, was minus 17 degrees below zero, Centigrade.
"This freezing," he explained ' 'decreases acids formed in the stomach. Relief, however, is only temporary. In about three weeks the acids are back. Why not freeze the ulcer every three weeks? Because, in my opinion, this is a very dangerous pro­cedure since the temperature cannot be safely controlled. If the fluid becomes too cold, then the entire lining or wall of the stomach could be destroyed. Only 13 per cent of our 300 patients were completely re­lieved through freezing."
Other speakers at the con­vention, which is attracting about 1000 persons to the vari­ous sessions, said:
1.   Since  most  adolescents dread the idea of going to a psychiatrist the family doctor should try to help them with their problems.
2.   Leukemia cells, trapped in  the brain,  don't  respond to most leukemia drugs.
3.   When people are facing death, its' up to the doctor to decide  whether or not they can be told the whole truth.
Dr. J. Roswell Gallagher, of Boston, Mass., said most ad­olescents need someone to lis­ten to them sympathetically during the trying teen-age years.
FAMILY DOCTOR
"I think the family doctor can do a good job here," added the physician, who is chief of the Adolescent Unit at Chil­dren's Hospital Medical Cen­ter. "Of course if the family doctor can make no progress, | the possibility of sending the j adolescent to the psychiatrist! has to be considered. But onlyl as a last resort. Most adoles­cents react badly to the 'headj shrinker'," as they call him. They say " 'Aw, Doc, if I go to him, people will think I'm nuts'!"
Dr. Gallagner said if the ad­olescent is obviously suffering from a psychiatric disorder the family doctor can prepare him for his visit to the psychiatrist by explaining to him that there's actually "nothing queer or unreasonable about such a visit."
Dr. Gallagher said he enjoys dealing with adolescents.
"If these young people think you're their friend, they're most appreciative," he added. "They need someone to listen sympathetically to them during the years in which they are try­ing to break away from their parents."
LEUKEMIA DISCUSSED Central nervous system leu­kemia, a leukemia involving the brain or the covering of the brain, was discussed at the con­vention by Dr. Margaret Ly­man, of New York city, the only woman speaker at the con­vention.
Dr. Lyman, whose youth and beauty belie the high reputation she has gained as a leukemia expert, said "often leukemia cells become trapped in the brain."
"Leukemia, as you know, is generally in the blood stream. But blood goes to the brain. So leukemia can also be in the brain," explained the physician, who is instructor of the depart­ment of pediatrics, Cornell Uni­versity Medical College.
Dr. Lyman said "when we send drugs, used to treat other leukemias, into the blood stream in quest of the leukemia cells in the brain, the brain keeps them out."
"Why? Because the brain is very particular about what it lets in," the pediatrician ex­plained. "For certain chemi­cal   and   physical   reasons, many drugs just don't get into the   brain,   Yet  these  same drugs are the ones which are proving  effective  in  helping leukemia of the liver or leu­kemia of the bone marrow." Dr.  Lyman  said fortunately there is a drug called predni-sone, which will help leukemia of the brain, as will injections
into the spine of a drug called methotrexate, she added. X-RAY THERAPY
1 'Methotrexate," e x p 1 ained the pediatrician, "will flow over the covering of the brain and destroy the leukemia cells. A third method is X-ray therapy for the head and spine."
Dr. Lyman said although today's leukemia patient can live as long as 14 months, com­pared wtih the four-months-life-span of 1958, there's still no (cure for this disease.
"I may be indulging in a dream," the woman pediatri­cian added, "But I cannot help but hope that some day a break­through may come in the field of immunity. Say the body could be made to cure itself by rejecting cancer cells in much the same way that people today reject the foreign tissue of transplants."
Dr. Lyman said most older children realize they are suf­fering from a fatal disease and this is especially true when they refuse to talk about it.
Another speaker, Dr. John B. Reckless, Durham, N. C, dis­cussed the problem of how much to tell a person who has been stricken with a fatal disease.
'DEPENDS ON PATIENT'
"It all depends on the pa­tient," said Dr. Reckless, who is associate in psychiatry at Duke University Medical Cen­ter. "Some people want to know everything about their illness so they can make proper ar­rangements for themselves and for their families. As a rule) such people can be told the truth about their condition. And although they may not like the idea of dying, they feel more peaceful with the knowledge. They are grateful that they have been given a chance to prepare themselves."
Dr. Reckless said at the other extreme are the patients who go into mental depression or extreme panic when they learn they are facing death.
"Wifh them," said the psychi­atrist, "the family faces a very serious decision. How much of the truth can they take without^ panicking? I advocate telling* such people as much as they can safely handle. I don't be­lieve in lying. But if you realize that the patient in question does not really want to know the truth, you can say, 'This condi­tion can be fatal but in your case we cannot be sure."