It is mostly likely that Dent suffered from what is now known to be a duodenal peptic ulcer caused by the bacterium Helicobacter Pylori (H. pylori), only discovered in 1983, and now easily treatable by antibiotics and acid suppression. But in Dent's day treatment was mostly guesswork, and the results could be prolonged and extremely uncomfortable; apart from the physical pain and disruption, the mental strain of never knowing when it might blow up again did not add to the quality of life. The operations often had long-term side-effects, as did Dent’s, and he was lucky not to have died from a perforation of the ulcer, a common side-effect. Judging from his reported symptoms, he must have had continuous inflammation of the duodenum (duodenitis), of various degrees of severity, causing symptoms of abdominal pain in between the acute ulceration phases, which would have been very debilitating. Aspirin may have been one of his painkillers, terrible for his ulcer; even Alka-Seltzer contained aspirin. The milk of magnesia he took may have given him his severe diarrhoea.

Dent's lifelong smoking would have been a major contributing factor to his ulceration. In the early twentieth century, stress was considered to be the main cause of peptic ulcers. Treatment – as Dent's by Conway Davies – was medical: bed rest and bland diet, especially milk. Judging by the comments of his surgeon W.R. Douglas, Dent's was a large duodenal ulcer, and he probably had a partial gastrectomy, removing the part of the stomach which secretes acid, but it could have been something different. The stomach-pumping tube beforehand was fairly standard, keeping the stomach as free as possible of acid to try to heal the ulcer, and he would have had a drip to keep him hydrated. Severe haemorrhage from duodenal ulcers was a dangerous complication. This could manifest itself, as it did in 1939 – when it may have been treated by ‘oversewing’ the ulcer, darning it to stop the vessel from bleeding – by the patient vomiting up the blood; or, as it did in 1952, by ‘melaena’, where the blood is not vomited but passes through the bowel and is passed as a black tarry stool, called melaena, which is possibly what Dent meant by ‘black haemorrhage’.

With thanks to Dr Judith Murray-Rust and Dr Carol Evans