Fatal Effect of Total Loss of Gastric Juice. ∗

Abstract

The present experiments were undertaken to determine the effect of the total loss of gastric juice from the body under conditions not complicated by obstruction such as are present after closure of the pylorus. Recourse was made to a method described by Lim, Ivy, and McCarthy 1 with this important modification that the vagus nerves to the isolated stomach were left intact. The stomach was cut across at the cardia and the pylorus. The cardiac end of the stomach was then inverted and closed and the open pyloric end brought to the surface as a fistula. An anastomosis was made between the lower end of the esophagus and the duodenum. Great care was taken in sectioning the cardia not to interfere with the vagus fibers to the stomach and as much of the blood supply to the isolated stomach was left as was technically possible. To date we have made 3 such preparations but the data to be presented here are from a single animal. At autopsy the vagus nerves to the isolated stomach in this animal were found intact. A daily record was kept of the water and food intake (food exclusively milk and muscle), the urinary output, and the quantity and composition of the gastric secretion collected from the isolated stomach. In addition blood was drawn at the end of each 24 hr. period and determinations made of the CO₂ combining power of the blood plasma, the blood pH, and the NPN, urea N, and chloride concentration.

The following points have been established: (1) The total loss of the gastric secretion from the body causes death in the dog with symptoms of weakness, anorexia, oliguria and profound depression. (2) Accompanying these symptoms and proportionate to their severity occurs a prompt fall in blood chloride, an increase in the CO₂ combining power of the plasma, an increase in the pH, and a late increase in the NPN and urea N. (3) The symptoms may be relieved and the blood chemistry returned toward the normal by the intravenous injection of from 2,000 to 3,000 cc. of Ringer's solution or 0.9% NaCl solution per 24 hrs. (4) The isolated stomach, with intact blood and vagal supply, will frequently secrete in 24 hrs. from 1000 to 1600 cc. of gastric juice with a chloride concentration of 0.5 to 0.55%.