Abstract
In several papers I have pointed out the frequency of polycythemia or polyglobulia in patients suffering with non-bleeding duodenal ulcer. I have also called attention to the presence of eosinpenia in such patients. In gastric ulcer occurs just the reverse anemia and relative eosinophilia.
Of eighteen operatively demonstrated cases of duodenal ulcer, in fifteen polyglobulia was found, while of twelve cases of gastric ulcer, polycythemia was noted only in one.
For details I refer to my article, which will soon appear in the Journal of the Am. Med. Sc.
The question arose, what has duodenal ulcer to do with polyglobulia. As several investigators who injected adrenalin in dogs and in men, have found an increase in erythrocytes from 30-70 and 100 per cent (this experimental polyglobulia lasting sometimes about thirty hours) and also a reduction in the number of eosinophiles, the idea has gained access to us, that the initial lesion of duodenal ulcer may be caused by hyperfunction of the adrenals.
As in none of our patients with duodenal ulcer high blood pressure was noted, the assumption was, that in such patients a slight excess of epinephrin may circulate in the blood in quantities not sufficient to cause hypertention, but enough to exert its hormone influence upon the duodenal mucosa.
I have succeeded in producing duodenal lesions and ulcers in eight dogs by subcutaneous and intravenous injections of adrenalin hydrochloride in a period of about one to two weeks daily (with one or two intermissions). Single doses did not exceed 3 mg. subcutaneously and 2½ mg. intravenously.
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