The general mortality rate among patients suffering from peptic ulcer has been materially reduced by surgical care. The reduction has been due chiefly to early operation in those having one type of ulcer lesion; that is, ruptured ulcer.1The rate following operations for chronic peptic ulcer, uncomplicated by rupture or gross hemorrhage, has always been much lower, but proportionate progress in reducing this figure further has not been made. This rate has remained for some time at a relatively stationary level of about 10 per cent,2except in selected series. To present further observations on the sequence of events leading to this sustained rate is my object in this communication. The ordinary patient chronically ill with peptic ulcer is to be dealt with here. Those patients with ruptured peptic ulcer, with acute hemorrhage or with gastrojejunal ulcer are naturally not under consideration, since they all present preoperative and