Abstract
The transitory achlorhydrias might present a clinical material suitable for the study of the unknown mechanism by which a strong mineral acid is being constantly produced by certain cells of the gastric mucosa. Whether this type of achylia will prove more useful than animal experiments depends upon several factors, one being the pathogenesis of this transient inhibition. Faber 1 has recently restated his well known view upon the achylias, including the transitory forms, as expressions of an anatomically manifested gastritis. Faber mentions the occurrence of achylia in intestinal diseases, particularly dysentery, typhoid, and paratyphoid fever, and points out the slow and gradual recovery from the achylia as the common course of events. Observations during induced fever in dogs and during experimentally produced hyperthermia led Carlson 2 and his co-workers to reckon with functional inhibition of cell activity rather than with histological changes of more stable nature.
By substituting the histamine test for the test meal the gastric secretion can be studied during severe fevers without inconvenience to the patients. In this series the histamine dose has been 0.5 mg. ergamine (Burroughs Welcome). The test has been carried out on a fasting stomach. The stomach was not washed previous to the subcutaneous injection, but the fasting contents had been withdrawn. With this small dose of histamine the highest free acidity was obtained in the juice secreted during the second 10-minute period after the injection. The sample analyzed represents the secretion during the first 20-minute period after the injection. Thus the values are not strictly maximum values. Günzburg's test has been carried out on all samples giving a free acidity below 20. We consider this essential.
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