Levulose, Glycocoll and Alanin. 169 



but that the increased heat production following carbohydrate 

 ingestion is due to the mass action of sugar molecules. On the 

 contrary, amino-acids or the oxy- or keto-acids produced from them 

 act as stimuli upon the cells thereby increasing the heat production. 



104 (921) 



The production of duodenal lesions and ulcers in dogs by injections 

 of epinephrin and of gastric lesions and ulcers in rabbits 

 by extirpation of the adrenals. 



By G. A. Friedman, M.D. 



[From the Department of Clinical Pathology, Columbia University.] 



In several papers I have pointed out the frequency of polycy- 

 themia or polyglobulia in patients suffering with non-bleeding 

 duodenal ulcer. I have also called attention to the presence of 

 eosinpenia in such patients. In gastric ulcer occurs just the reverse 

 anemia and relative eosinophilia. 



Of eighteen operatively demonstrated cases of duodenal ulcer, 

 in fifteen polyglobulia was found, while of twelve cases of gastric 

 ulcer, polycythemia was noted only in one. 



For details I refer to my article, which will soon appear in the 

 Journal of the Am. Med. Sc. 



The question arose, what has duodenal ulcer to do with poly- 

 globulia. As several investigators who injected adrenalin in dogs 

 and in men, have found an increase in erythrocytes from 30-70 

 and 100 per cent (this experimental polyglobulia lasting some- 

 times about thirty hours) and also a reduction in the number of 

 eosinophiles, the idea has gained access to us, that the initial lesion 

 of duodenal ulcer may be caused by hyperfunction of the adrenals. 



As in none of our patients with duodenal ulcer high blood 

 pressure was noted, the assumption was, that in such patients a 

 slight excess of epinephrin may circulate in the blood in quantities 

 not sufficient to cause hypertention, but enough to exert its 

 hormone influence upon the duodenal mucosa. 



I have succeeded in producing duodenal lesions and ulcers in 

 eight dogs by subcutaneous and intravenous injections of adrenalin 

 hydrochloride in a period of about one to two weeks daily (with 



