220 STOMACH DIGESTION. 



erature ? When we must work for our living and cannot have 

 the benefit of the dietetic kitchen at all times, we must have an 

 active gastric juice to at least partially disinfect and dissolve our 

 food, and a person who secretes no gastric juice is or soon becomes 

 a patient. 



" In a recent article on achylia gastrica, by F. Martius and O. 

 Lubarsch, the authors arrive at the conclusion that neither simple 

 achylia nor that dependent upon atrophy of the mucosa (anadenia) 

 can bring about severe anemic or cachectic conditions, unless motor 

 insufficiency, atrophy of the intestinal mucosa, or general diseases 

 (tuberculosis, lues, infections, etc.) are added. Even if this is 

 true, generally speaking, it does not disprove the statement that 

 absence of HC1 in the gastric secretion compels the individual to 

 lead the life of a patient, for dyspepsia and dystrypsia may exist 

 and become severe without the anatomic changes spoken of by 

 Martius and Lubarsch. But, over and beyond this, Flint, Fen- 

 wick, Quincke, Nothnagel, Osier, Kinnicut, also Rosenheim and 

 G. Meyer, have described cases of pernicious anemia in which 

 atrophy of the gastric mucosa was, at the autopsy, found to be 

 the only organic disease existing. It is conceivable that the in- 

 testine cannot persistently digest an amount of proteid sufficient 

 to maintain the nitrogen-equilibrium during work ; that it depends 

 upon a certain part of this proteolysis to be performed by the 

 stomach ; that the acid gastric chyme is necessary for the stimu- 

 lation of the duodenal secretions. Pawlow has proved experi- 

 mentally that the gastric HC1 is an important stimulant to the 

 secretion of pancreatic juice. It is probable that digestion in the 

 duodenum is not perfect without the acid proteids, which, as we 

 know, cause increased diastasic action of the pancreatic juice. So 

 that we are justified in concluding on experimental and clinical 

 grounds that in the absence of secretion of HC1 in the stomach 

 the entire duodenal digestion is abnormal.'' 



Artificial Gastric Juice. In addition to the observations 

 upon man and lower animals already referred to, many experi- 

 ments have been carried on with an artificial gastric juice made 

 by extracting the pepsin from the mucous membrane of the stom- 

 ach of the pig with glycerin, and adding to this glycerin-extract 

 0.2 per cent, of hydrochloric acid. The results of these experi- 

 ments are, however, not to be regarded as identical with those that 

 take place in the stomach of a living being. The factors in the 

 problem are many, and some of them are still undetermined. 



Effect of Alcohol on Digestion. This subject has already 

 been fully discussed, and the reader is referred to p. 159. 



