“消化系统疾病诊治为什么困难?”这是一个极其难以论述的题目。在临床医学上可以理解只有消化系领域是难以诊治的。在同样的内科系临床医师中,专门的消化系医师和循环系医师对疾病的看法和思考态度则不同。明确地说,循环系医师是计数思考,而消化系医师是形态学思考、这大概就是形态学这一名词产生于消化系的原因。消化系疾病诊断依靠形态学诊断这一特征,消化系病理学(特别是消化道系统),恐怕至今还存在着学问上的偏见。一、形态学诊断的现状1985年华盛顿世界胃肠病学会议选编了田崎勇三的“日本胃癌的临床”一文,这篇文章可以说如实反映了日本当时消化系统的现状。据582例胃癌初诊时的腹部触诊,触到肿瘤的比例为59.1%,这恐怕是保守的说法。如增加在X 线透视下触诊,78%的胃癌可触知。经手术证实胃癌的术前正确 “Why digestive diseases diagnosis and treatment difficult?” This is an extremely difficult topic to discuss. In clinical medicine, it is understandable that only the field of digestive diseases is difficult to diagnose and treat. Among the same physicians in the Department of Internal Medicine, specialized gastroenterologists and cycle physicians have different attitudes and reflections on the disease. Specifically, the circulatory physician is counting and the physician of the digestive system is morphological thinking, presumably the reason that the term morphology comes from the digestive system. Diagnosis of digestive diseases rely on morphological diagnosis of this feature, digestive system pathology (especially the digestive system), I am afraid there is still a learned bias. First, the status of morphological diagnosis 1985 World Gastroenterology Conference in Washington selected Takesaki Yasushi’s “Japan’s stomach cancer clinical” article, this article can be said to accurately reflect Japan’s digestive system status quo. According to 582 cases of stomach cancer palpation when first visit, the proportion of tumor touched 59.1%, which I am afraid is conservative. As with palpation under fluoroscopy, 78% of gastric cancers are palpable. Surgical confirmation of gastric cancer preoperative correct