750 FEED C. KOCH 



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Clinical Application of Secretin. The clinical use of secretin prep- 

 arations has been recommended by various physicians and manufacturers, 

 but never on a good scientific basis, nor on experimental observations. In 

 the first place, the products on the market do not appear to be physio- 

 logically tested, let alone standardized, and in the second place, practically 

 all of the products are recommended to be given by mouth. As already 

 stated, this mode of administration is not physiologically sound. The 

 only efficient method of experimentally demonstrating secretin activity is 

 to employ the intravenous injection. This, however, is hazardous clin- 

 ically with an impure, unstandardized extract as we have to deal with in 

 the case of secretin. Simon (1907) made a careful study of the effect of 

 the repeated injection of a secretin solution prepared according to Bay- 

 liss and Starling. In one dog he observed a violent reaction resulting in a 

 bloody diarrhea almost immediately after the injection. At autopsy the 

 intestines showed a general bloody appearance and the capillaries were 

 considerably dilated. In two other dogs repeated injections over a period 

 of ten days and four months respectively, usually were followed by an 

 intermittent myxorrhea and later by a chronic form thereof. Histological 

 examination showed that one injection brings about a gathering of eosino- 

 philes to the surface of the intestines and almost a complete depletion 

 thereof in the bone marrow and spleen. 



In spite of the contra-indications as to the oral administration of 

 secretin, a number of clinicians report favorable results therewith in 

 pyloric stenosis, pancreatic insufficiency, as a hepatic stimulant, and as a 

 stimulant to peristalsis in colonic stasis. Beveridge claims to have ob- 

 tained good results in more than a hundred cases. Ewald obtained a 

 favorable result in one out of thirteen cases, and Ilarrower (a) (b) recom- 

 mends its use in many digestive disorders. Carlson, Lebensohn and Pearl- 

 mann (1916) give a very good summary in their paper on the therapeutic 

 value of secretin, and they show very clearly that the commercial secretin 

 preparations "secretogen" and "duodenin" are free from both secretin and 

 prosecretin. 



Motilin or Peristaltic Hormone. A frequent response following the 

 injection of either gastrin or secretin preparations is increased gastric 

 and intestinal motility. Weil and (1912) observed that the immersion of 

 rabbits' intestines in Tyrode's solution at 38 C. yields an extract which, 

 by direct contact with another intestine, causes a contraction. He found 

 this activity in the stomach and small and large intestines. Spleen, 

 muscle, heart, liver, brain and kidney extracts acted inconsistently or 

 negatively. The active substance appears to be very similar in chemical 

 properties to gastrin, histamin and secretin. The most purified product, 

 as used intravenously on the rabbit by Wei land (1912), caused no saliva- 

 tion, no fever, and no flow of tears, but diarrhea, segmentation and peris- 

 talsis. In the dog, a fall in blood pressure was noted together with 



