Some cases of
pyloric stenosis cured without surgical intervention
by Dr. Donato Perez Garcia
A paper presented at the Ninth
National Assembly of Surgeons,
Mexico City, November 1950.
Translated to English from Spanish by
Maria Anabel Cañon
Scanning and editing by Chris Duffield.
Reference was made to Aime Ricci's English translation
of Dr. Perez Garcia's 1953 book, Cellular
Therapy, chapter 3, where updated
versions of some cases, and x-ray images can be found.
Dr. Perez Garcia giving his lecture
to the doctors at the
Ninth National Assembly of Surgeons, Mexico City,
Doctors listening to Dr. Perez Garcia.
Now that surgery has reached its greatest splendor, I would like to
present this paper about the medical treatment of pyloric stenosis, which
has always been treated surgically due to its mechanical nature. It seems
absurd even to think it might be treated otherwise. But the facts I am going
to show demonstrate that the medical treatment I call Cellular Therapy
offers more advantages because: there are neither risks of surgical shock
nor post-surgery complications, and it is not necessary to prescribe any
life-long diet or special care, as is usual with such patients. My
observations from more than five years of treating the most serious patients
make me think that it should be true with the majority of cases treated with
Stenosis occurs due to an obstruction in the lumen of the pylorus, either
in its walls or their contour, caused by a strange body, a pediculated
vegetation or lesions in the walls, usually of cancerous origin, though the
most frequent are those caused by duodenal, prepyloric, juxtapyloric, and
duodenal pyloric ulcers. We shall not mention stenosis caused by external
factors. Pyloric stenosis, due almost always to an ulcerous or neoplastic
process of the duodenum, is the most frequent, and we shall talk about it.
The canal lumen can be obstructed for 1-10 cm. It is almost always
eccentric and allows the passage of a certain amount of liquid. When
obstruction begins, the gastric muscle exaggerates its peristalsis, then is
exhausted and, at last, atony appears and chyle is accumulated in the
gastric bottom, thus extending the walls of the stomach, which may reach
Radiologically, gastric ptosis is differentiated from the dilation
produced by stenosis because with ptosis the stomach adopts an almost
spherical figure, and its vertical diameter is larger than the transverse
one. On the other hand, the form adopted in stenosis is that of a crescent
moon; the transverse diameter is larger than the vertical diameter.
Peristaltic movements are almost nonexistent, and gradually disappear as
Let us mention first the x-ray study that always makes or clarifies the
The symptom that generally opens the scene is the sensation of gastric
pressure that the patient experiences. This increases for up to two or three
hours after taking any food. It quickly turns into a painful cramp that is
almost always mitigated by the ingestion of some food or antacid. The nausea
continues, and finally there is vomiting: first of sour liquid and then of
food, between 4 and 7 hours after being ingested. Vomiting produces a great
relief to the patient. As a consequence, severe constipation alternating
with false diarrhea is common. When this local condition is reached, the
general condition of health has been greatly affected: general asthenia,
deep paleness, and emaciation.
Having just summarized pyloric stenosis clinically and radiologically, I
am now going to present some cases treated with Cellular Therapy.
All the patients treated are ambulatory, so follow up has been very
difficult. For this reason I am going to present a few cases that have been
CLINICAL HISTORY 1
Mr. CM. 66 years old, 56 kilograms, and 90 mg/dL average fasting
glycemia. Occupation: peasant. May, 1944.
Neither personal nor pathological antecedents of importance.
He has been suffering from indefinite digestive disorders for the past 30
years. During the last 20 years he has
visited many doctors. But in spite of the medication prescribed for his
disease, the following main symptoms have been established in the last 5
years: intense pain in the pit of the
stomach, accompanied for the last year by vomits that occurred one hour
after eating. At first they were sour liquids, now he vomits all meals.
Sometimes they occur at night and are preceded by pain that disappears with
the vomiting of the food he has eaten during the day. They are sometimes
fetid in odor and taste. Pain has become
more intense lately and the patient has had sensations of stretching,
cramps, or laceration. Again, he feels better after vomiting the gastric
contents. Vomits are incoercible and medication cannot stop them. The
continuous pain has hardly allowed him to sleep one hour in the past seven
months. He has not evacuated his bowels for periods of up to 15 days;
usually he is able to do so with an enema every 8 days.
Loss of weight is clear: he has lost 20 kg in the last 7 months. He also
suffers from deep asthenia and his general aspect is that of a seriously ill
The belly presents a very irregular shape: above the navel it appears
expanded, with convex shape; below the navel it looks more like a trough.
Palpation in the upper part produces pain and muscular defense. The colonic
flexure is perfectly palpated in both sides; there is pronounced meteorism
in the upper part of the abdomen and faint in the lower part: with
exploration maneuvers the eyes become more receded, the outlines of the face
more drawn, the nose sharper; in short, the facie is clearly peritoneal.
Breathing is superficial and accelerated: 25 respirations and 106
pulsations per minute; blood pressure: 125/70.
The radiological study says: “... strong gastric dilation, especially at
the level of the antrum, with pronounced enlargement of the stomach;
transverse diameter is larger than vertical diameter. Abundant liquid during
fasting. In the x-rays taken in standing position, non-persistent minor
curvature deformations can be seen. By the eighth hour, a small quantity of
the barium has gone into the intestine, while the rest is still in the
stomach. .... Radiological evaluation: advanced pyloric stenosis. The cause
of this stenosis is not perceived radiologically; its origin could be
ulcerous, neoplastic, etc… Dr. José Ramírez Ulloa.”
The strong gastric dilation, with predominance of the transverse diameter
over the vertical one, the permanence of barium for more than eight hours,
and the small quantity of this element gone into the intestine, are
conclusive radiological facts for diagnosing advanced pyloric stenosis,
corroborating the clinical diagnosis.
Applications of the healing medical system I call Cellular Therapy were
made every five days. From the third one on, there was an evident
improvement. With the fourth treatment, vomiting disappeared, pain
decreased, and the patient began evacuating his intestines. This improvement
allowed us to apply the treatment every eight days. In all, the patient
received seven treatments. All his digestive functions had been regulated,
he was feeling healthy, and he had gained 10 kilos in two months when the
treatment was brought to an end. Without being discharged and, therefore,
without previous examination, he stopped his treatment.
Four and half years later, the patient reappeared. To corroborate his
evident health state he was radiologically examined, with the following
result: “Mr. C.M.... The strong gastric dilation has disappeared, especially
at the level of the antrum… The air chamber is now normal… very little
liquid during fasting… Deformations in the minor curvature have disappeared…
A persistent duodenal diverticulum can be seen in all x-rays... Some gastric
spasms near the duodenal bulb... Barium goes through the duodenum, and that
has made it possible to observe the diverticulum… Dr. Jose Ramirez Ulloa.”
The patient had been diagnosed, both clinically and radiologically, with
advanced pyloric stenosis due to duodenal ulcer. Four years after receiving
an incomplete Cellular Therapy course of treatment, it was verified, both
clinically and radiologically, that the advanced pyloric stenosis had
CLINICAL HISTORY 2
“Mr. A.V., 35 years old, 62 kg, 78 mg/dL blood glucose; employed. He was
examined on June 4, 1946.
For two months he had suffered from tertiary malaria, gonorrhea, and
syphilitic chancre. Syphilis reactions in blood have always been positive,
even though he has been methodically treated for his intense infection
during the past five years. In March of this year, Kahn’s reaction in
cerebrospinal fluid was positive, with a slight increase of albumin.
More than five years ago, that is, before positive reactions in blood,
the ingestion of certain foods caused him intense stomach ache that would
disappear with antacids. That has changed in the last months. The pain is
more intense before meals, and food makes it disappear, which has motivated
him to eat food at any time to mitigate the pain. But now the pain has
For the past 22 days, not even the ingestion of food will relieve him, and
the pain has extended to the whole abdomen; standing on his feet also
increases it. He always has gas, that increases when he has any food. Gas
expulsion relieves him but also causes him intense rectal pain. In one month
he has lost 11 kilos and all his strength.
The abdomen looks swollen due to gas; there is extended pain; palpation
produces muscular defense. Palpation of the liver edges is painful; the
splenic area is large. Blood pressure is 110/65.
The radiological study says: “... in the pyloric area there is a very
notable deformation caused by a repletion defect that includes also the
duodenal bulb and the first portion of the duodenum. The radiological image
of the bulb is limited by a slim flexure corresponding to the small
curvature of the organ, while the rest of the image has disappeared. The
flexure presents a recessed shape in its inferior edge, giving it a
paracyclical aspect. The first portion of the duodenum presents an irregular
form with festooned or toothed edges. Manual pressure produces localized
pain in the area. Stenosed duodenal ulcer with carcinomatous process in the
stomach pyloric area, duodenal bulb, and first portion of the duodenum… Dr.
Manuel Herrera Sobreyra."
The progressive and rapid clinical development and the radiological data
confirm the diagnosis of pyloric stenosis due to a syphilitic carcinomatous
process of the duodenum.
Following the standard procedure for this therapy, the patient was
administered 30 units of insulin intravenously. 35 minutes later,
hypoglycemic symptoms appeared, but they stopped some minutes later. After
one hour he was administered 25 more units, without obtaining the desired
symptoms. 45 minutes later the dosage was again increased by 20 units, and
20 minutes after this third injection he began showing all the typical
symptoms of the change of blood properties. 28 minutes after reaching its
maximum (the sought after therapeutic moment), he was administered
- 4’–3’–acetylamino–3’–glucosamine–4’–oxyacetate of sodium
- Dextrose 10g,
- Water 100cc,
to inject 4cc of this solution;
- Calcium gluconate 1g,
- Calcium bromide 1g,
- and calcium formate 1g,
given in 20cc 50% dextrose solution;
- Magnesium bromide 500mg,
- Vitamin B1 20mg,
- Vitamin B2 6mg,
- Vitamin B6 6mg,
- Nicotinamide 400mg,
- Vitamin C 100mg,
in 10cc 50% dextrose solution
- and 10cc of a 5% solution of hydrolyzed casein, until filling a 20cc
- Tartrobismuth of sodium and potassium 100mg,
- Tryptophan 20mg,
- Histidine 200mg,
- Parathyroid 40 Units Collip,
these last medications intramuscularly.
At the second presentation of the symptoms of changes of the blood
properties, he ingested bismuth and aluminum salts with 250 mg of
nicotinic acid in sweetened water.
He received this treatment every five days; but since he began feeling
much better after the first three treatments, they were then administered
every eight days. The irregular effect observed after the first treatment
normalized by the sixth treatment. In the three last treatments he was
administered 90 units of insulin intravenously. The average time for the
first presentation of symptoms was 40 minutes, and at 73 minutes they
reached their peak. In all he received 10 treatments and finally felt
completely healthy; he could eat all kinds of food without discomfort. He
stopped the treatment without radiological and clinical examination.
On April 26, 1948, two years later, Mr. A.V. came to see us again. Looking
perfectly healthy, he said he only came to thank us for his being in such
good health. I requested he let us take some x-rays and he promised to; but
he was like all outpatients: as soon as they improve, they quit their
treatments. In October, 1948, two and a half years after treatment, he sent
me a letter from which I quote the following paragraphs: “... you saved my
life, since the opinion of several doctors was that surgery was needed
immediately… when I met you I weighed only 62 kilos, when my normal weight
is 84 kilos. Each of the six x-rays showed a duodenal ulcer… I felt better
with the first treatment, and from then on my health continued improving.
After the tenth treatment I was completely healthy and had recovered my
weight: 92 kilos… A.V."
The complete suppression of all digestive disorders, the notable increase
of weight, and the return to normal activity of the subject after more than
two and a half years, lead us to think that the pyloric communication was
restored and that the patient, without undergoing the standard surgical
intervention for this condition, can be considered healthy again.
CLINICAL HISTORY 3
“Mr. F.P.G., 56 years old, 55 kg, average fasting glycemia 70 mg/dL, army
man, December 1944.
His father died due to an intestinal ailment; his mother due to a
non-defined gastric ailment; his wife had two abortions and they have two
For many years he drank great quantities of alcohol; he suffered from
syphilis and was intensively treated until reactions to it were negative and
all symptoms disappeared.
In February, 1942 he had peritonitis caused by an acute appendicitis that
was treated and cured with Cellular Therapy. He also recovered 12 kilos he
had lost. To verify his state of health state after the treatment, a
laparotomy was performed: it showed a floating appendix without any
In December, 1944, he suddenly felt an intense pain in the epigastrium,
accompanied by nausea and general discomfort that medication could not
relieve. As his condition worsened, he went to the Military Central
Hospital. Dr. Mario Quiñonez performed the clinical examination and Dr. C.
Gomez del Campo the radiological study. Diagnoses from both physicians were:
“Stenosed duodenal ulcer; needs immediate surgical intervention…”
Apparently without dyspeptic antecedents, he began suffering from
epigastric pain with nausea. This was followed by vomiting for a month, sour
at first, watery and burning later. He finally began vomiting food with a
strong odor. For almost two months he was put on painkillers that did not
relieve his pain. Loss of strength and emaciation were the results of the
acute state of those two months.
Examination showed peritoneal facie, and an emaciated and palid subject
who displays much pain. Abdomen distended with gas, muscular defense or
simply abdominal pressure. Palpation produces peristaltic movements that
bring on pain, followed by expulsion of gases that relieve the patient.
During exploration maneuvers the patient had vomiting with butyric odor.
On March 11 of the same year, he underwent the first application of
Cellular Therapy, with the following medications:
-30 units of insulin, intravenously;
- 4’-3’–acetylamino–3’–glucosamine–4’–oxyacetate of sodium
- Dextrose 10g,
- Water 100cc,
to inject 6cc of the solution;
- Calcium bromide 350mg,
- Calcium gluconate 120mg,
- Calcium formate 50mg,
in 50% dextrose solution, until completing 20cc;
another syringe of 20cc, containing:
- Vitamin B1 20mg,
- Vitamin B2 6mg,
- Vitamin B6 6mg,
- Nicotinamide 40mg,
- Ascorbic acid 100mg,
in 50% dextrose solution;
- Hydrochlorate of histidine 200mg,
- Tryptophan 20mg,
- Folliculin [Estrone] 50,000 Units,
these last three medications to be applied intramuscularly.
At the second presentation of the symptoms of change of the blood
properties, aluminum and bismuth salts with 250 mg. of nicotinic acid in
sweetened water were administered.
After the first treatment, all symptoms began to clearly disappear, so
that he could leave the therapy after only two treatments, without any
medication. After that, they were reinitiated until he completed ten
On August 18 of the same year, Dr. J. Ramirez Ulloa said in his
radiological study: ".... Stomach is filled like those of orthotonic type.
Normal air chamber. No liquid is observed during fasting. Normal shape,
volume, and situation, without deformations in the contour, nor accidents in
the curvatures. No dilation in the pyloric antrum indicating stenosing
process. Duodenum… no shades of ulcerous niches are observed... August 18,
1945. Dr. J. Ramírez Ulloa.”
To this date, the patient effectively carries
out all his activities, and does not follow any special diet; he is in
CLINICAL HISTORY 4
Mr. J.P.P., 47 years old, 59 kg, 80 mg/dL average fasting glycemia.
September 29, 1950.
He had amebic dysentery, Malta fever, and digestive disorders all his
life. He has been deaf in the right ear since childhood.
During the last year and a half, digestive disorders increased. The most
constant and annoying symptom has been the sensation of inflation in the
abdomen that becomes stronger after meals. He has a burning sensation in the
esophagus and has had vomiting for the last two months. In the last fifteen
days he vomits everything, and food does not stay in his stomach. For this
reason he has lost 14 kilos in this short period of time.
Distressed facies, enlarged liver palpable in its borders, painful right
colic flexure. Blood pressure: 110/85.
Radiological study carried out by Dr. Emma Rosa Corominos Galvez says:
".... Very large stomach, hypotonic, with a very low bottom in bucket shape.
There is pain from pressure in the duodenal bulb, which is only filled by
manual pressure. Peristalsis is clearly diminished but it exists, and it
passes a little through the pylorus… In the other x-rays it was not possible
to find an even slightly impregnated duodenal bulb... Radiologically:
Gastric atony. Pyloric stenosis due to possible duodenal ulcer. Dr. Emma
Rosa Coromina Galvez. September 12, 1950.”
Clinical data are not enough to diagnose pyloric stenosis, but those
given by the radiological study are clear enough, as can be seen in the
On September 29 he received the first treatment. Two days later he began
taking liquid food that he no longer vomited. By the third day, he stopped
vomiting solid food as well. Seven days later he received the second
treatment, and one week later he got the third one. The therapy was
interrupted before the fourth treatment because the patient believed he was
cured. But he ate to excess in quantity and quality and he vomited three
times in 15 days. This alarm made him resume treatment on November 3.
He has received two more treatments, and his improvement is even more
remarkable. Once a series of 10 treatments without interruptions is
finished, I expect x-rays to be taken to either discharge him or continue
CLINICAL HISTORY 5
E.D.M., female, 38 years old, 60 kg, 80 mg/dL average fasting glycemia;
rural teacher. She was examined on October 4 this year. 
One brother died of duodenal ulcer.
In 1941, without any apparent reason, she suddenly felt an intense
stomachache that lasted two days. With some injections the pain disappeared
and everything went back to normal.
In August 1945 at midnight, and again without apparent cause, she had
vomits and epigastric pain. She took a laxative of castor oil at daybreak
and remained a few months without discomfort.
In 1948 a very intense pain below the ribs, near the hepatic area,
accompanied vomits; the clinical diagnosis was Cholelithiasis. She was
prescribed milk, eggs, and medication for ulcer, but would vomit everything
with intense pain. During the last days of such a diet she was being
administered daily six ampoules of Sedol. Her nutritional diet was changed
to cornmeal drinks without milk and gelatin, and that brought about
improvement. X-rays showed that there was no ulcer. In June, 1948, she
underwent surgery that revealed a gall bladder in perfect state; but there
was a cyst that obstructed the lumen of the biliary duct. She went back to
eggs and milk, doing fine for almost a year. But by the end of 1949, vomits
and pain started again without apparent reason.
X-rays were taken of the stomach and duodenum, and the latter was found
to be healed. In spite of this, her condition kept worsening, and by the end
of September and the beginning of October the pain was the same day and
night. She vomited everything she ate some fifteen minutes after ingesting
it, whether liquid or solid. In fact, she could not eat at all for a month.
Constipation increased. During that period of time she lost 20 kilos.
A continuous Ouch! of pain was the greeting of the patient. Her eyes were
sunken, her face pale and suffering. There was muscular defense above the
navel, and the slightest hand contact would increase the pain. Due to the
severity of her condition it was impossible to carry out even the slightest
examination. Blood pressure: 120/80.
The x-ray study says: "Dr. Jorge Segura Millan.... Small air chamber.
Small quantity of stasis liquid during fasting, normal esophageal transit,
normal filling, normal mucous creases, stomach very incurvated on itself and
with prepyloric portion dilated. Picture in persistent screen can be
observed in the small curvature during the initial phase of gastric
contractility; when contractions reach their greatest intensity, they
disappear from the previous picture. Normal mobility, without pain.
Contractions of normal initiation and shape, with very increased frequency
and intensity. Their intensity produces gastric segmentation but evacuation
is not in relation because of pyloric obstacle. Posterior small bulb, badly
inflated with undefined edges, painful. With compression there is no
perceptible suspended image. Evacuation is delayed, and in the final stages,
the intensity of the contractility decreases and there is a slight
expansion, mainly antral... Duodenal bulbar uncus in front with micro bulb
by retraction and periduodenitis. The preceding suggests incomplete pyloric
stenosis with initial hyper peristalsis and antral dilatation with following
hypotonia, relaxation, and gastric stasis. Dr. Jorge Segura Millan.”
On October 4, I administered the first Cellular Therapy treatment to her,
thus obtaining the almost complete disappearance of pain, and resumption of
daily intestinal evacuation. By the fifth treatment, vomits stopped and she
began taking meat, milk, juices, vegetables, and sweets.
I expect to discharge her as soon as she has received 15 treatments.
I. As shown in this paper, there is a non-invasive procedure,
other than surgery, to treat pyloric stenosis. It should be tried by all
physicians expert in this disease, so that they can make their own
a. As soon as the correct diagnosis of stenosis is made, this
treatment should be systematically applied; and only if it fails, resort
b. Observation of these patients must continue over time to
assure the efficacy of the therapy.<0} Even if this therapy has only had
temporary effects, it can be administered again if the patient returns
with the same or similar symptoms.
II. — Since the true cause of pyloric stenosis is outside the
affected mucosa, and because it is a general disease with local effects, all
the treatments in vogue, medical or surgical, are only temporarily
III. — For the present we can say that, since this treatment has
worked in the majority of cases, it must be considered as truly addressing
the cause, and therefore it is the most rational treatment for pyloric
Mexico City, November 1950.