REGULATION OF THE PANCREATIC SECRETION. 233 



A defective secretion of gastric juice, be its cause what it 

 may, is of medical importance from other points of view 

 than that it interferes with the proper digestion of proteins. 

 A lack of hydrochloric acid in the stomach allows the develop- 

 ment here of a large number and variety of bacteria which 

 in its presence is impossible. The development of these 

 bacteria is associated with fermentative changes in the 

 stomach contents, which assume clinical importance in pro- 

 portion to their character and amount. Lack of free hydro- 

 chloric acid in the stomach delays the opening of the pyloric 

 sphincter, which leads to retention of the food in the stomach 

 for longer periods of time than normally. In this way also 

 bacterial fermentation is allowed to become more effective. 



When ultimately the stomach contents pass into the small 

 intestine, they flood this portion of the alimentary tract with 

 bacteria and, as already pointed out, the bactericidal activity 

 of the small intestine is by no means limitless. The fermenta- 

 tive changes in the food initiated in the stomach may in con- 

 sequence continue in the intestine, with effects upon the 

 organism as a whole (due in part to absorption of the bacterial 

 products formed, in part to a lack of properly digested foods) 

 which are sometimes unimportant, sometimes serious. 



A deficient amount of gastric juice leads to yet other dis- 

 turbances in the organism. We are slowly beginning to 

 recognize the intimate connection which exists between 

 different organs in the body and how the proper behavior 

 of one is dependent upon that of another. This relation 

 between organs exists also between different portions of the 

 alimentary tract. It might be thought at first that from 

 the standpoint of digestion alone a deficient amount of gastric 

 juice is without consequence, for the pancreas contains a 

 proteolytic ferment which is able to split proteins even more 

 readily than the acid-proteinase of the stomach. Matters 

 are not so simple, however. It was seen above that the 

 presence of acids in the duodenum brings about a secretion 

 of pancreatic juice. If now the gastric secretion is de- 



