EXPLANATION OF THE EFFECTS OF ALKALIES. 145 



A discussion of some further medical questions may here be taken up. 

 The first concerns the therapeutic use of the neutral and alkaline salts of 

 sodium. In clinical, pharmacological, and physiological text-books it is 

 stated now, as ever, that these salts promote a flow of gastric juice. We 

 may look in vain, however, for any experimental foundation to support 

 this doctrine. The experiments brought forward cannot be regarded 

 as conclusive. When Blondlot sprinkled sodium bicarbonate upon flesh, 

 or Braun and Griitzner introduced sodium chloride solutions directly 

 into the blood, they began with methods either false in themselves, or far 

 removed from normal conditions. In this case, however, the gaps in 

 the experiment were happily made good by the clinician, for the experi- 

 ment appeared to be confirmatory of clinical experience. That sodium 

 salts (the chloride and bicarbonate) are useful in disorders of the 

 digestive apparatus there can be no doubt. How do they act, however? 

 It appears to me that here, as in some other cases, medical science has 

 fallen into error. When we know that an effect takes place it does 

 not by any means imply that we know the mechanism by which it 

 occurs, and although medicine is broad enough and comprehensive 

 enough to make free use of empiricism in practice, yet it often 

 thinks in narrow grooves when it turns to the explanation of facts. 

 It frequently tries to explain complicated healing processes in the 

 simplest way, on supposed physiological datn. And this is true in the 

 present case, which affords an example of prevalent medical reasoning ; 

 the alkalies work favourably in digestive disturbances ; therefore, they 

 are succagogues. Naturally the stomach, under the influence of alkalies, 

 sometimes begins to secrete a greater quantity of juice. This means, 

 however, that it has recovered from a disordered state, and has returned 

 to normal conditions. Consequently, the effect is due to the fact of 

 recovery, and not to a direct influence of the alkalies. This latter, 

 however, must be specially proved. The assistance afforded by the 

 alkalies to the organism might be capable of another explanation : 

 for example, that which is ordinarily given. In this case, how- 

 ever, I venture to offer a reason for the effects of sodium chloride, 

 and of the alkaline salts of sodium, which is exactly the opposite of 

 that generally accepted. We were unable to convince ourselves of any 

 succagogue influence on the part of these salts. Indeed, both on the 

 stomach and pancreas they proved in our hands to have an inhibitory 

 effect. In addition to the experiments which I previously brought 

 forward concerning the relation of alkalies to gastric and pancreatic 

 juice, I may relate the following observation : A dog which fortunately 

 had survived the performance, one after the other, of a gastric fistula, 

 a^pancreatic fistula, and an cosophagotomy, received daily during the 

 course of several weeks an addition of soda to its food. The animal 



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