BispebjergHospital_1913-38

105 Summary.

The effect of acid therapy upon the acidity of the gastric contents has been examined directly in 19 patients suffering from complete achlorhydria. Ewald’s test meal (35 grams crushed rusk and 250 grams tea vithout sugar or milk) was used and the effect of hydro­ chloric acid, citric acid and betainhydrochloride investigated. Samples were withdrawn from the stomach every 10 minutes and in each sample the acidity was determined through titration with n/10 so­ dium hydroxide, congo-red and phenolphthalein being used as indi­ cators; the hydrogen ion concentration was determined with the potentiometer. , The investigations showed that in the majority of the cases, the effect of acid administered together with the food to patients with achlorhydria is much less than would be expected theoretically and from examinations in vitro. A remarkable lowering of the aci­ dity takes place in the stomach, only relatively few of the samples withdrawn giving a positive reaction to congo-red, and the acid administered most often being neutralized before the stomach is empty. It is considered possible that the lowering of the acidity is — caused by neutralization with regurgitant duodenal juice, and that this is especially pronounced because patients with achlorhydria have a bad pyloric function. 74, 23 (1924). — 2. Baltzer, F .: Arch. f. V erdauungskr. 56, 35 (1934). — 3. Bennet, T. Izod, Ryle, J . A .: G uy’s Hosp. Rep. 71, 283 (1921). — 4. Bie, V.: Ugeskr. f. Læger 81, 825 (1919).— 5. Boldyreff, W. N .: Pflügers Arch. 121, 13 (1908). — 6. Boldyreff, W. N .: Q uart. J . exper. Physiol. 8, 1 (1914). — 7. Boi­ dyreff, W. N .: Am. j . Physiol. 105, 10 (1933). — 7 a. Boldyreff, W. N .: Acta med. Sc. 82, 111 (1934). — 8. Bolton, C.: L ancet 214, 1263 (1928). — 9. Bolton, C., Goodhart, G. W .: Lancet. 420 (1922). — 10. Bolton, G., Goodhart, G. W .: J . Physiol. 77, 287 (1933). — 11. Bolton, C., Goodhart, G. W .: J . Physiol. 87, 360 (1936). — 12. Carlson, A . J .: (1916) cit. Macleod, Physiol, in mod. Med. p. 461, 7. Udg. (1935). — 13. Crohn, B. B .: Am. J. med. Sc. 156, 656 (1918). — 14. Ege, R .: Ugeskr. f. Læger 84, 1227 (1922). — 15. Elman, R., Eckert, C. T .: Proc. Soc. exp. biol. a. med. 30, 1343 (1933). — 16. Foster, N . B .: Am. J . med. Sc. 133, 303 (1907). — 17. Griffiths, W. J .: J . Physiol. 87, 34 (1936). — 18. Helmer, O. M .: Am. J . Physiol. 110, 28 (1934— 35). — 19. Helmer, O. M ., Fouts, P . J., Zerfas, L. G.: J . biol. ehem. 105, 11 (1934). — 20. Hicks, C. J ., Vischer, J. W .: Am. J . Physiol. 39, 1 (1915). — 21. H ill, F. C., Henrich, L. C. Wilhelmj, C. M .: Surg. Gynec. Obst. 60, 966 (1935). — 22. Hollander, F .: J . biol. ehem. 97, 585 (1932). — 23. Mahlo, M ulli.: Dtsche. med. Wchnschr. 60, 937 (1934). — 24. Mac Cann, J. C.: Arch. Surg. 19, 600 (1929). — 25. Mac Cann, J. C.: Am. J. Physiol. 89, 483 (1929). — 26. Maclean, H., Griffiths, W. J .: J . Physiol. 65, 63 (1928). — 27. Maclean, H ., Griffiths, W. J .: J . P h y ­ siol. 65, 77 (1928). — 28. Olch, J. Y., Elman, R .: Proc. Soc. exp. biol. a. med. 25, 184 (1928). — 29. Pavlov, I. P .: The work of the digestive glands. 2. Engl. Ed. (1910). — 30. Roholm, K .: Acta. med. Sc. 79, 331 (1932). — 31. Rosemann, R .: Pflügers Arch. 118, 467 (1907). — 32. Shay, H ., Katz, A . B., Schloss, E. M .: Litteratur. 1. Baird, M . Me., Campbell, J . M . H., Hern, J . R. B .: Guy’s Hosp. Rep.