Search

Acid inhibition and duodenal regurgitation have been shown to play important roles in the regulation of the gastric secretory curve in the normal human subject.

Beside the previously described changes in capillary resistance occurring after a period of latency and lasting for several days or weeks, another type of response was found in both human subjects and experimental animals which sets in promptly and wears off within 4 hours. It is suggested that this be termed ‘immediate capillary stress response’ for the sake of distinction from the ‘late capillary response.’ Both immediate and late responses may show patterns of increase, decrease and biphasic reaction or there may be upon the same stress no change in the capillary resistance at all. Since the immediate capillary stress response, in contrast to the late response, appears in the adrenalectomized animal as well as in the intact animal, it is postulated not to be dependent on the adrenal cortex.

(1) The preparation and use of a new test meal consisting of two per cent Liebig’s extract containing phenol red is described. The advantages of this meal over other commonly used test meals are discussed.

Man's interest in his own digestive processes goes back many centuries. | The views on digestion held by all the ancient peoples and tribes were full of magic, mysticism and superstition. Either demons or different humors existed in the body to direct the natural digestive processes. | The ideas of the ancients were not essentially different from those of the Greeks, whose philosophy exercised so profound an influence upon their medicine, or from the ideas of the Romans. | Hippocrates, Plato, Aristotle, Galen, taught that gastric digestion was brought about by a sort of internal cooking or coction, possibly through the agency of the "innate heat11 of the body, derived from the blood,one of the four cardinal fluids. | And this was the belief subscribed to by scientists for the next one thousand years. Scientific thought had been tremendously influenced by the philosophy of Plato, in which reflection and contemplation were uppermost. Observations by the senses, ideas born as a result of observations, experiments to verify these ideas, the study of facts - these were disregarded. Men began to deduce underlying physiological principles and to explain vital phenomena by mental speculations only. This method was to retard the advance of our knowledge of physiology until men learned to think scientifically and to fully appreciate the scientific method.

1. Following the Mann-Williamson operation the acidity of the total secretions entering the stomach is much higher than before operation. During the gastric secretory curve the acidity of the secretions continues to rise and does not show the normal terminal decrease. The non-acid secretions entering the stomach are either very small in amount or absent. These changes are due to the absence of duodenal regurgitation. 2. The emptying time of the stomach is markedly increased after operation due apparently to jejunal spasm. 3. The acidity of the gastriccontents shows little change after operation. 4. Evidence is presented which indicates that the acidity of thetotal secretions (gastric plus duodenal) entering the stomach is controlled primarily by duodenal regurgitation while the acidity of the gastriccontents is controlled primarily by acid inhibition.

The physiological control of gastric acidity depends upon the following factors: 1. Strength of the acid secreted. 2. Regurgitation of non-acid secretions from the duodenum. 3. Inhibition of the intragastric chemical phase of acid secretion due to the presence of acid in the stomach and of the intestinal phase of acid secretion due to the presence of acid in the intestine. 4. The intensity of the stimuli arising in the pars pylorica and the degree to which, in a given animal, they influence the intragastric chemical phase of acid secretion. 5. Vagal or cephalic influences. 6. Absorption of water from the gastric contents.

Treatment of herpes zoster is supportive. The physician should prescribe analgesics for pain and treat the skin lesions with wet compresses, powders and ointments. Bacterial infection should be treated promptly. If secondary bacterial infection is not present, topical steroids may promote healing.

Advances in the field of immunology during the last few decades have been startling, provocative, and potentially far reaching. One important phase of this brilliant work has been the concept of "autoimmune disease." This new concept that an organism can develop widespread or localized tissue disease because it has turned on itself with the weapon of hypersensitivity owes its existence to fundamental work begun early in the century during which 2 important observations were made. The first of these was the observation that organs possess serologic specificity. In 1904, Nuttall, injecting serum from various animal species into rabbits, showed that the antibody then produced by each rabbit would distinguish in the precipitin reaction between the serum used to immunize that rabbit and serum from another species. Uhlenhuth noted the first example of true organ specificity, however, when he found that optic lens antigen was specific for the optic lens no

We were unable to determine the exact dose of phenolphthalein to give uniform results. We found that dogs with jaundice gave false positive reactions. The fact that the test was variable in acutely produced ulcers would seem definitely to exclude it as a test for determining the presence of ulceration of the gastrointestinal tract in the experimental animal.

Partial gastrectomy has in recent years been coming more and more into prominence in the treatment of duodenal ulcer. The all too frequent occurrence of marginal ulcer after gastro-enterostomy has led surgeons to seek some method of approach to the problem of duodenal ulcer by which the acidity of the gastric secretions could be reduced and the incidence of marginal ulcer diminished. The studies of Klein,1Lewisohn and Ginzburg,2Lewisohn and Feldman,3de Takats,4Winkelstein,5Crohn,6Wilensky and Crohn,7McCann8and others seem to leave little doubt that after partial gastrectomy there is a definite reduction in gastric acidity. When one attempts to explain this reduction in acidity, however, one is confronted with a great deal of conflicting evidence; before the value of partial gastrectomy in the treatment of duodenal ulcer can be determined, some more definite information as to its mode

While conducting a series of observations on the effect of intravenously injected emulsified fat on the emptying of the gallbladder of cats, we fortuitously encountered a case of pancreatic bladder. Although twenty-three cases of well defined pancreatic bladders have been recorded in the literature during the last twenty-three years, the anomaly is exceedingly rare; it appears only in the domestic cat. Since this is the first time an anomaly of this sort has been observed in our laboratory, and since its structure so satisfactorily supports the hypothesis of a pancreatic origin, we are including the description of the case in the slowly accumulating literature on aberrant pancreatic lobes and vesicles. Boyden 1 (1925) not only described six new cases of the aberrant variation, but presented for the first time adequate histologic and embryologic data in support of the origin for pancreatic bladders wholly independent of the extrahepatic biliary system. Bean

Posterior gastro-enterostomy performed in properly selected cases has long been accepted as one of the most satisfactory procedures in the treatment of duodenal ulcer. Two reasons have generally been advanced in explanation of its efficacy. First, it has been stated that the formation of a gastro-enterostomy stoma allows the gastric contents to pass into the jejunum without going through the duodenum, thereby removing the irritation of acid and food and allowing the ulcer to heal. Roentgenologists have taught, however, that in most patients unless the pylorus is completely obstructed the gastric contents leave the stomach to a large degree not through the gastro-enterostomy stoma but through the pylorus; and in spite of the fact that the ulcer continues to be exposed to the irritation of gastric contents, though perhaps for not so long a time, it usually proceeds to heal. The second explanation which has been offered is that gastro-enterostomy