Abstract THE EXTERNAL output of acid by the stomach has been assumed by many to be a direct measurement of the secretory state of the parietal cell mass. However, it is now generally accepted that the primary acid secretion of the stomach is altered by some mechanism which has been called acidity control. Pavlov's suggestion that gastric mucous or duodenal regurgitation was responsible for acidity control has little support at the present time. Two conflicting theories are now considered pertinent. Hollander1 has formulated the two-component theory of acid secretion which hypothesizes a concurrent secretion of an alkaline solution by the gastric mucosa, which partially dilutes and neutralizes the primary acid secreted by the parietal cells. This theory has gained recent support from Gray and Bucher2 and Makhlouf et al.3 In 1933, Teorell4 proposed that acidity control was accomplished by an exchange-diffusion of intraluminal hydrogen ions for interstitial References 1. Hollander, F.: Studies in Gastric Secretion: V. The Composition of Gastric Juice as a Function of Its Acidity , J Biol Chem 104:33-42 ( (Jan) ) 1934. 2. Gray, J.S., and Bucher, G.R.: The Composition of Gastric Juice as a Function of the Rate of Secretion , Amer J Physiol 133:542-550 ( (July) ) 1941. 3. Makhlouf, G.M.; McManus, J.P.A.; and Card, W.I.: A Quantitative Statement of the Two-Component Hypothesis of Gastric Secretion , Gastroenterology 51:149-171 ( (Aug) ) 1966. 4. Teorell, T.: Untersuchungen über die magensaftsekretion , Scand Arch Physiol 66:225-317, 1933.Crossref 5. Terner, G.: The Reduction of Gastric Acidity by Back-Diffusion of Hydrogen Ions Through the Mucosa , Biochem J 45:150-158, 1949. 6. Elliot, A.; Risholm, L.; and Obrink, K.J.: The Exchange Diffusion of Hydrochloric Acid Through the Gastric Mucosa in Man , Acta Med Scand 110:267-281, 1942.Crossref 7. Linder, A.E., et al: Electrolyte Changes in the Human Stomach Following Instillation of Acid Solutions , Clin Sci 25:195-205 ( (Dec) ) 1963. 8. Berkowitz, J.M., and Janowitz, H.D.: Alteration in Composition of Hydrochloric Acid Solutions by Gastric Mucosa , Amer J Physiol 210:216-220 ( (Jan) ) 1966. 9. Wlodek, G.K., and Leach, R.K.: The Effect of Histamine Stimulation on the Net Ionic Fluxes in Heidenhain and Pavlov Fundic Pouches , Canad J Surg 10:47-52 ( (Jan) ) 1967. 10. Wlodek, G.K., and Leach, R.K.: Effects of Histamine, Feeding, and Insulin Hypoglycemia on Net Ionic Fluxes in Gastric Pouches , Arch Surg 93:175-181 ( (July) ) 1966.Crossref 11. Schales, O., and Schales, S.S.: A Simple and Accurate Method of the Determination of Chloride in Biological Fluids , J Biol Chem 140:879-884 ( (Sept) ) 1941. 12. Gregory, R.A., and Tracy, H.J.: The Constitution and Properties of Two Gastrins Extracted From Hog Antral Mucosa , Gut 5:103-117 ( (April) ) 1964.Crossref 13. Wormsley, K.; Mahoney, M.P.; and Ng, M.: Effects of a Gastrinlike Pentapeptide (I.C.I. 50, 123) on Stomach and Pancreas , Lancet 290:993-996 ( (May) ) 1966.Crossref 14. Makhlouf, G.M.; McManus, J.P.A.; and Card, W.I.: Action of the Pentapeptide (I.C.I. 50, 123) on Gastric Secretion in Man , Gastroenterology 51:455-465 ( (Oct) ) 1966. 15. Hollander, F.: Gastric Secretion of Electrolytes , Fed Proc 2:706-714 ( (Sept) ) 1952. 16. Fisher, R.B., and Hunt, J.N.: The Inorganic Components of Gastric Secretion , J Physiol 3:138-149 ( (April) ) 1950. 17. Babkin, B.P.; Hebb, C.O.; and Krueger, L.: Changes in the Secretory Activity of the Gastric Glands Resulting From the Application of Acetic Acid Solutions to the Gastric Mucosa , Quart J Exp Pysiol 31:63-77, 1941. 18. Davenport, H.W.: Gastric Mucosal Injury by Fatty and Acetylsalicylic Acids , Gastroenterology 46:245-253 ( (March) ) 1964. 19. Davenport, H.W.: Salicylate Damage to the Gastric Mucosal Barrier , New Eng J Med 276:1307-1312 ( (Sept) ) 1967.Crossref 20. Altamirano, M.: Alkaline Secretion Produced by Intra-arterial Acetylcholine , J Physiol 168:787-803 ( (Oct) ) 1963. 21. Martin, L.M.; Morganstern, M.; and Carroll, M.L.: Gastric Secretion—the Electrolytes Before and Their Changes at Various Periods After Histamine Stimulation , Ann Intern Med 6:91-98, 1932.Crossref 22. Kurtz, L.D., and Clark, B.B.: The Inverse Relationship of the Secretion of Hydrochloric Acid to the Tension of Carbon Dioxide in the Stomach , Gastroenterology 9:594-602 ( (Nov) ) 1947. 23. Davenport, H.W.; Warner, H.A.; and Code, C.F.: Functional Significance of Gastric Mucosal Barrier to Sodium , Gastroenterology 47:142-152 ( (Aug) ) 1964. 24. Wlodek, G.K., and Leach, R.K.: A Method for the Continuous Measurement of Net Ionic Fluxes in Gastric Pouches , Canad J Surg 9:237-241 ( (July) ) 1966. 25. Code, C.F., et al: The Influence of Acid on the Gastric Absorption of Water, Sodium and Potassium , J Physiol 166:110-119 ( (April) ) 1963. 26. Eisenman, A.I., et al: The Transfer of Ions Across the Stomach Wall, Studied by Means of Radioactive Isotopes , J Biol Chem 140:35-37 ( (April) ) 1941. 27. Code, C.F., et al: Barrier Offered by Gastric Mucosa to Absorption of Sodium , Amer J Physiol 183:604 ( (Oct) -Dec) 1955. 28. Cope, O.; Cohn, W.E.; and Brenizer, A.G., Jr.: Gastric Secretion: II. Absorption of Radioactive Sodium From Pouches of the Body and Antrum of the Dog , J Clin Invest 22:103-110 ( (Jan) ) 1943.Crossref 29. Cope, O.; Blatt, H.; and Ball, M.R.: Gastric Secretion: III. The Absorption of Heavy Water From the Pouches of the Body and Antrum of the Stomach of the Dog , J Clin Invest 22:111-116 ( (Jan) ) 1943.Crossref 30. Moll, J.C., and Code, C.F.: Rates of Insorption of Sodium and Potassium From Stomachs of Rats , Amer J Physiol 203:229-230 ( (Aug) ) 1962. 31. Ridley, P.: Electrolytes, Pepsin and Gastric Motility After Histamine and Insulin in Chronic Fistula Rats , Fed Proc 22:1088 ( (July) -Aug) 1963. 32. Parker, J.G.; Werther, J.L; and Hollander, F.: Electrolytes in Gastric Secretion of a Patient With Complete Esophageal Obstruction and Permanent Gastrostomy , J Mount Sinai Hospital NY 27:482-486, 1960. 33. Ihre, B.: Human Gastric Secretion , Acta Med Scand (suppl 95) , p 220 (Nov) 1938.
Archives of Surgery – American Medical Association
Published: Sep 1, 1968