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GASTRIC SECRETION: V. ACHLORHYDRIA FOLLOWING PARTIAL GASTRECTOMY FOR ULCER: STUDIES WITH HISTAMINE AND THE TRANSPLANTED GASTRIC POUCH

GASTRIC SECRETION: V. ACHLORHYDRIA FOLLOWING PARTIAL GASTRECTOMY FOR ULCER: STUDIES WITH... Abstract The operation of partial gastrectomy has furnished an opportunity for the study of many of the problems of gastric physiology. The present paper is not primarily concerned with the results following this procedure. These have recently been discussed by Berg,1 who introduced the operation in this country as the procedure of choice in the treatment of gastric and duodenal ulcer. But in spite of the numerous advances in physiology and their evident bearing on the subject, there still exists an apparent misunderstanding of the mechanisms involved. Since considerations of function are at least as important as those of structure, it may not be amiss to emphasize again the underlying facts and at the same time add some clarifying experiments. The first point to grasp is that the gastric secretion following a meal is not a single response to one type of stimulus. It is the total of responses to References 1. Berg, A. A.: The Radical Operative Cure of Gastric and Duodenal Ulcer , S. Clin. North America 8:1167, 1928 2. The Mortality and Late Results of Subtotal Gastrectomy for the Radical Cure of Gastric and Duodenal Ulcer , Ann. Surg. 91:340, 1930. 3. (a) Uschakow: Dissert, St. Petersburg, p. 20 4. Babkin, B. P.: Die äussere Sekretion der Verdauungsdrüsen , Berlin, Julius Springer, 1928, p. 398. 5. (b) Pavlov, I. P.: The Work of the Digestive Glands , ed. 2, London, C. Griffin & Company, 1910. 6. (a) Klein, E., and Arnheim, E.: Gastric Secretion: I. A Transplanted Subcutaneous Gastric Pouch , Arch. Surg. 25:433 ( (Sept.) ) 1932.Crossref 7. (b) Ivy, A. C.: The Rôle of Hormones in Digestion , Physiol. Rev. 10:282, 1930. 8. (c) Babkin, B. P.: Die äussere Sekretion der Verdauungsdrüsen , Berlin, Julius Springer, 1928, p. 398. 9. Ivy, A. C.; Lim, R. K. S., and McCarthy, J. B.: The Intestinal Phase of Gastric Secretion , Quart. J. Exper. Physiol. 15:55, 1925. 10. Babkin,3c p. 190. 11. Klein, E.: Gastric Secretion: IV. Effect of Atropine on the Secretion of Transplanted Subcutaneous Gastric Pouches , Arch. Surg. 26:246 ( (Feb.) ) 1933.Crossref 12. Klein, E.: Gastric Secretion After Partial Gastrectomy , J. A. M. A. 89:1235 ( (Oct. 8) ) 1927.Crossref 13. Gross, W.: Beitrag zur Kenntnis der Sekretionsbedingungen des Magens nach Versuchen am Hund , Arch. f. Verdauungskr. 12:507, 1906.Crossref 14. Sawitsch, W., and Zeliony, G.: Zur Physiologie des Pylorus , Arch. f. d. ges. Physiol. 150:128, 1913.Crossref 15. Smidt, H.: Experimentelle Studien am nach Pavlov isolierten kleinen Magen über die sekretorische Arbeit der Magendrüsen nach den Resektionen Billroth I und II, sowie nach der Pylorusausschaltung nach v. Eiselsberg , Arch. f. klin. Chir. 125:26, 1923. 16. The possibility that some of the secretion of acid which persists is due to stimuli of parenteric origin also cannot be excluded. 17. Portis, S. A., and Portis, B.: Effects of Subtotal Gastrectomy on Gastric Secretion , J. A. M. A. 86:836 ( (March 20) ) 1926.Crossref 18. Sokolov, quoted by Pavlov.2b 19. Lim, R. K. S.; Ivy, A. C., and McCarthy, J. B.: Contributions to Physiology of Gastric Secretion by Local and Chemical Stimulation , Quart. J. Exper. Physiol. 15:13, 1925. 20. Experiments are now under way to determine whether some part of the preoperative hyperacidity so common in cases of duodenal ulcer is due to interference with inhibition from the duodenum. 21. Klein, E.: Left Vagus Section and Partial Gastrectomy for Duodenal Ulcer with Hyperacidity , Ann. Surg. 90:165 ( (July) ) 1929.Crossref 22. Babkin, B. P.: The Value of Histamine as a Test of Gastric Secretion from a Physiological Point of View , Canad. M. A. J. 23:268, 1930. 23. Thus a patient operated on for gastric polyps five years after gastrectomy for ulcer showed normal mucous membrane in the stomach (microscopic examination). There was no recurrence of the ulcer. 24. Winkelstein, A.: Gastric Secretion After Partial Gastrectomy for Ulcer , Am. J. Surg. 7:494, 1929.Crossref 25. Comfort, Mandred W., and Osterberg, Arnold E.: Gastric Secretion After Stimulation with Histamine , J. A. M. A. 97:1141 ( (Oct. 17) ) 1931.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

GASTRIC SECRETION: V. ACHLORHYDRIA FOLLOWING PARTIAL GASTRECTOMY FOR ULCER: STUDIES WITH HISTAMINE AND THE TRANSPLANTED GASTRIC POUCH

Archives of Surgery , Volume 30 (1) – Jan 1, 1935

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Publisher
American Medical Association
Copyright
Copyright © 1935 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1935.01180070165009
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Abstract

Abstract The operation of partial gastrectomy has furnished an opportunity for the study of many of the problems of gastric physiology. The present paper is not primarily concerned with the results following this procedure. These have recently been discussed by Berg,1 who introduced the operation in this country as the procedure of choice in the treatment of gastric and duodenal ulcer. But in spite of the numerous advances in physiology and their evident bearing on the subject, there still exists an apparent misunderstanding of the mechanisms involved. Since considerations of function are at least as important as those of structure, it may not be amiss to emphasize again the underlying facts and at the same time add some clarifying experiments. The first point to grasp is that the gastric secretion following a meal is not a single response to one type of stimulus. It is the total of responses to References 1. Berg, A. A.: The Radical Operative Cure of Gastric and Duodenal Ulcer , S. Clin. North America 8:1167, 1928 2. The Mortality and Late Results of Subtotal Gastrectomy for the Radical Cure of Gastric and Duodenal Ulcer , Ann. Surg. 91:340, 1930. 3. (a) Uschakow: Dissert, St. Petersburg, p. 20 4. Babkin, B. P.: Die äussere Sekretion der Verdauungsdrüsen , Berlin, Julius Springer, 1928, p. 398. 5. (b) Pavlov, I. P.: The Work of the Digestive Glands , ed. 2, London, C. Griffin & Company, 1910. 6. (a) Klein, E., and Arnheim, E.: Gastric Secretion: I. A Transplanted Subcutaneous Gastric Pouch , Arch. Surg. 25:433 ( (Sept.) ) 1932.Crossref 7. (b) Ivy, A. C.: The Rôle of Hormones in Digestion , Physiol. Rev. 10:282, 1930. 8. (c) Babkin, B. P.: Die äussere Sekretion der Verdauungsdrüsen , Berlin, Julius Springer, 1928, p. 398. 9. Ivy, A. C.; Lim, R. K. S., and McCarthy, J. B.: The Intestinal Phase of Gastric Secretion , Quart. J. Exper. Physiol. 15:55, 1925. 10. Babkin,3c p. 190. 11. Klein, E.: Gastric Secretion: IV. Effect of Atropine on the Secretion of Transplanted Subcutaneous Gastric Pouches , Arch. Surg. 26:246 ( (Feb.) ) 1933.Crossref 12. Klein, E.: Gastric Secretion After Partial Gastrectomy , J. A. M. A. 89:1235 ( (Oct. 8) ) 1927.Crossref 13. Gross, W.: Beitrag zur Kenntnis der Sekretionsbedingungen des Magens nach Versuchen am Hund , Arch. f. Verdauungskr. 12:507, 1906.Crossref 14. Sawitsch, W., and Zeliony, G.: Zur Physiologie des Pylorus , Arch. f. d. ges. Physiol. 150:128, 1913.Crossref 15. Smidt, H.: Experimentelle Studien am nach Pavlov isolierten kleinen Magen über die sekretorische Arbeit der Magendrüsen nach den Resektionen Billroth I und II, sowie nach der Pylorusausschaltung nach v. Eiselsberg , Arch. f. klin. Chir. 125:26, 1923. 16. The possibility that some of the secretion of acid which persists is due to stimuli of parenteric origin also cannot be excluded. 17. Portis, S. A., and Portis, B.: Effects of Subtotal Gastrectomy on Gastric Secretion , J. A. M. A. 86:836 ( (March 20) ) 1926.Crossref 18. Sokolov, quoted by Pavlov.2b 19. Lim, R. K. S.; Ivy, A. C., and McCarthy, J. B.: Contributions to Physiology of Gastric Secretion by Local and Chemical Stimulation , Quart. J. Exper. Physiol. 15:13, 1925. 20. Experiments are now under way to determine whether some part of the preoperative hyperacidity so common in cases of duodenal ulcer is due to interference with inhibition from the duodenum. 21. Klein, E.: Left Vagus Section and Partial Gastrectomy for Duodenal Ulcer with Hyperacidity , Ann. Surg. 90:165 ( (July) ) 1929.Crossref 22. Babkin, B. P.: The Value of Histamine as a Test of Gastric Secretion from a Physiological Point of View , Canad. M. A. J. 23:268, 1930. 23. Thus a patient operated on for gastric polyps five years after gastrectomy for ulcer showed normal mucous membrane in the stomach (microscopic examination). There was no recurrence of the ulcer. 24. Winkelstein, A.: Gastric Secretion After Partial Gastrectomy for Ulcer , Am. J. Surg. 7:494, 1929.Crossref 25. Comfort, Mandred W., and Osterberg, Arnold E.: Gastric Secretion After Stimulation with Histamine , J. A. M. A. 97:1141 ( (Oct. 17) ) 1931.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 1935

References