The gastric and pancreatic secretions of the newborn

Abstract

I have been able by means of a simple duodenal catheter to obtain for the first time access to the duodenum in the living infant. This has enabled me to investigate the secretion of the upper part of the small intestine. This catheter is, in brief, merely a Nelaton soft rubber catheter No. 14 (F). That I actually do reach the intestine is proved by X ray photographs which I show.

The present report concerns solely newborn infants, which had never obtained any nourishment. I have found some interesting conditions not only as concerns intestinal secretions but also regarding the secretion of the gastric juice. It is noteworthy that there have been no previous investigations in this regard; in fact I have been able to find note of only one test of the gastric secretion of the newborn before it has been given food.

I found that in almost all cases hydrochloric acid is present in the stomach of these newborn infants whether they are examined one half hour or twenty hours after birth. The hydrochloric acid varies from 1/2 cu. cm. to about 7 cu. cm., and is not in direct proportion to the age of the child. This hydrochloric acid is not stimulated merely by the passage of the tube, for it was obtained within a minute or two after the catheter was introduced. It, therefore, must have another origin. I believe that it is a reflex due to the sucking of the tube. The longer the catheter is kept in the stomach the more juice is obtained; in one hour 14 cu. cm. was obtained; in an hour and 50 minutes 17 cu. cm. This gastric juice has an acidity on an average of about 50.