Free Hydrochloric Acid Research Articles

Dichloro aluminum aminoacetate, a new anti-perspirant and deodorant

Although aluminum chloride is undoubtedly the best underarm deodorant and antiperspirant, it suffers from the disadvantage that it readily hydrolyzes to yield free hydrochloric acid which will cause tenderization of fabrics and skin irritation. The addition of buffering agents, such as urea, helps control free acidity but these buffers may be more readily removed from the skin by moisture than the aluminum salt. We have prepared the readily soluble salt dichloro aluminum aminoacetate which possesses an internal buffer in the NH2 group. It shows some promise as an effective deodorant.

Neurological Complications in Pernicious Anemia

DDISONIAN pernicious anemia is generally considered to be a conditioned deficiency disease. It is characterized by macrocytic anemia, in which there is an increase in the average size of the red blood cells, megaloblastic bone marrow, absence of free hydrochloric acid in the gastric juice, sclerosis of both the posterior and lateral columns of the spinal cord, and a specific response to liver and liver substitutes. Thus not

Megaloblastic bone marrow in liver disease

Cirrhosis of the liver accompanied by severe macrocytic anemia constitutes another disease entity which can be added to the list of conditions associated with megaloblastic proliferation in the bone marrow. ∗ ∗ Since submission of this manuscript for publication, another case of cirrhosis of the liver with megaloblastic anemia has come under our observation. In this patient the clinical diagnosis of cirrhosis was corroborated by the liver needle biopsy which showed extensive and far advanced fibrosis. There was moderately severe macrocytic anemia with a red blood count of 2.88 million and a hemoglobin of 11.1 Gm. There were 20 per cent megaloblasts in the sternal bone marrow material which was obtained by aspiration. In contrast to the other case herein reported this patient improved rapidly on minimal amounts of liver and a high caloric, high protein diet, with the blood count returning to practically normal limits within a short period of time. The patient had free hydrochloric acid in the gastric juice and gave no history of any gastrointestinal symptoms or glossitis. Evidence has been presented indicating that in such cases this phenomenon does not necessarily represent the coexistence of two diseases, cirrhosis and pernicious anemia, in one and the same patient.

Roentgenologic Deformities of the Pyloric Portion of the Stomach with Absence of Surgical and Pathological Findings

The enigma of pyloric filling defects without demonstrable pathology has intrigued us for years, and we have sought to discover some common denominator explaining the discrepancy between our radiologic observations and the findings of the surgeon and pathologist. In our study of pyloric defects we have found it feasible to refer to three groups: (a) those produced by mechanical pressure, whether of intraluminal, intramural, or extraluminal origin; (b) those due to physiological causes; (c) those which may be described as purely functional. Intraluminal conditions, such as polyps, hair balls, foreign bodies, etc., often cause pyloric defects. Intramural lesions, also, such as leiomyomata, may produce defects which at times resemble those due to malignant change. The extraluminal conditions that simulate malignant involvement of the pylorus are numerous. Many of them are related to inflammatory, benign, or malignant changes in the liver, pancreas, duodenum, gallbladder, or colon. Lymphnode enlargement from inflammation or metastatic involvement may also produce defects of the pylorus, due to the special arrangement of the lymphatics at that site. Physiological causes for pyloric filling defects include variations in the spinal contour, the presence of congenital mesenteric bands, variations in size and relationship of surrounding organs, etc. There are also filling defects which may be attributed to deranged or pathological physiology involving remote organs of the body, such as disease processes of the appendix, heart, lungs, kidneys, generative organs, and central nervous system. Finally we have the purely functional cases, in which we can find no pathologic basis for the pyloric changes but which nevertheless appear to constitute a definite entity. As may readily be appreciated from this classification, such a multiplicity of etiologic factors play a part in producing changes radiologically simulating pyloric disease that we have been unable to determine a common factor which can be said to be responsible for the pseudo-filling defects which we are discussing. The following cases in which a diagnosis of malignant changes of the pylorus was made, but in which surgery or autopsy failed to reveal any pyloric lesion, are more or less typical. Case I (Fig. 1): J. P., white male aged 60, entered the hospital in December 1939, complaining of weight loss, weakness, loss of appetite, dizziness, and the passage of black stools for the past ten days. He appeared well nourished and well developed. Physical examination revealed slight enlargement of the liver. No definite tumor could be palpated in the abdomen. Blood studies showed red cells 3,390,000; white cells 11,400; hemoglobin 8.8 gm. Stools were positive for blood. Gastric analysis showed no free hydrochloric acid. X-ray examination revealed an organic lesion involving the pars pylorica. The rugae were absent in this portion of the stomach, and no peristaltic waves passed through the pylorus.

THE NEOPLASTIC POTENTIALITIES OF MOUSE EMBRYO TISSUES

Epithelial tumors have been readily obtained by the implantation of embryo stomach tissue together with olive oil containing methylcholanthrene (with or without Scharlach R) in adult mice of homologous strain. The implanted tissue from the squamous portion of the stomach rapidly encysted the oil, and benign and malignant papillomas and squamous cell carcinomas soon arose from the stratified squamous lining of the cysts. Bits of the glandular portion of the stomach also formed cysts, but the gland cells underwent metaplasia in response to the carcinogen, altering first to transitional epithelium and then to a stratified squamous layer. So swiftly did these changes take place that nearly all of the tumors took origin from epithelium that had already become stratified and squamous, and the growths themselves were of this type. A single transitional cell carcinoma and an adenoacanthoma were procured, but no adenocarcinomas; nor did any benign papillomas develop, though they often resulted from the action of methylcholanthrene on the squamous portion of the embryo stomach. Search failed to disclose any distinctive precancerous changes in the gastric tissue. Five of the cancers were transplanted and they grew in every host. No tumors arose from any of the numerous control implants. Those consisting of glandular tissue formed cysts lined partly with columnar epithelium secreting mucus and partly with tubular glands equipped with chief and parietal cells in good condition. Pepsin and rennin were found in the fluid contained in these cysts, but no free hydrochloric acid. The enzymes were present also when the cysts contained methylcholanthrene and the glands had not yet been wholly replaced by metaplastic epithelium. The tumors appeared months sooner than when methylcholanthrene is injected into the stomach of adult animals or given by mouth; some of them were well established after 5 or 6 weeks. They arose regularly when the requisite experimental conditions were provided. The utilization of transplanted embryo tissue provides a means whereby gastric tumors free from bacterial infection can be procured swiftly and easily.

Gastric acidity in apparently healthy individuals

1. Gastric data, including maximum total acidity, maximum free hydrochloric acid, the time of occurrence of each, and the shape of curve of total acidity have been presented for 50 apparently healthy subjects. 2. Similar gastric data obtained by repeated analyses on 13 apparently healthy subjects are also included. 3. Comparisons have been drawn between the socalled normal values listed in modern textbooks and those actually obtained from the two groups of apparently healthy subjects.

Aluminum phosphate gel in the treatment of peptic ulcer

1. The effects of aluminum phosphate gel on peptic ulcer were studied in 22 patients; one group of 15 with bleeding peptic ulcer and another group of 7 with uncomplicated peptic ulcer. A third group of 15 additional patients, serving as controls, were treated with the usual ulcer regimen. The first group included 3 gastric ulcers, 11 duodenal ulcers, and 1 gastro-duodenal ulcer; the second group consisted of 2 gastric ulcers, 4 duodenal ulcers, and 1 gastro-duodenal ulcer. The third group included 3 gastric ulcers, 8 duodenal ulcers and 4 gastric-duodenal ulcers. The patients comprised 32 males and 5 females, ranging in age from 28 to 72 years. 2. Aluminum phosphate gel produced rapid marked roentgenographic improvement and cure in a much higher percentage than did the usual ulcer regimen with or without aluminum hydroxide gel. The aluminum phosphate gel produced prompt relief of ulcer pain, had an excellent effect on appetite and return of strength, and was much less constipating than the aluminum hydroxide gel. There was a moderate reduction of free hydrochloric acid and total acidity. There was no change in mineral metabolism as measured by the blood calcium and phosphorus, nor was there any effect on the increase of the blood urea nitrogen commonly observed in bleeding peptic ulcer. 3. The erythropoietic response following bleeding peptic ulcer is determined by the degree of the anemia at the moment and is independent of the initial severity of the hemorrhage itself.

A comparison of gastric acidity among men and women suffering from duodenal ulcer as determined by fractional analysis of gastric contents after injection of histamine

A comparison of the gastric acidity of men and women suffering from duodenal ulcer shows that the male patients have much higher values than the female patients for free hydrochloric acid and total acid in response to the injection of histamine. The incidence of very high values, that is, equaling or exceeding 100 c.c. of tenth-normal sodium hydroxide, is greater for the series of male patients than it is for the female patients. The higher incidence of hyperacidity among the men may help to explain the greater tendency to intractability of duodenal ulcer among men. The gastric acidity of women suffering from peptic ulcer is usually not abnormal. Neurogenic causes, on the other hand, are usually very apparent among women who have duodenal ulcer. The utilization of this information is obviously clinically important in determining the type and intensity of treatment of duodenal ulcer.

Spontaneous Cholecystoduodenal Fistula in a Patient with a Primary Hepatoma of the Liver

A case of spontaneous cholecystoduodenal fistula in a patient with a primary hepatoma of the liver is here presented because of several points of interest: (1) the relative rarity of these conditions, and particularly the combination of the two in one patient, (2) the roentgen demonstration and correct interpretation of the findings, as confirmed at autopsy, (3) the racial and geographical significance of primary hepatic cancer. A 42-year-old corporal, a native of South America, was admitted to Winter General Hospital on Oct. 15, 1943, by transfer from a station hospital. He had entered the station hospital on Sept. 15, 1943, complaining of persistent dull epigastric pain. His appetite was good and there was no vomiting, although he had a sensation of obstruction in the stomach. There was no history of tarry or clay-colored stools. In 1938, the patient experienced an attack of severe epigastric pain which was relieved by a hypodermic injection. No diagnosis was made and he was comfortable up to the time of his admission, except for slight bloating lasting for a few minutes only. The blood findings, as determined at the station hospital, were: red cells, 4,200,000 and hemoglobin 89 per cent. Gastric analysis showed hyperchlorhydria. X-ray examination on Sept. 25 led to a diagnosis of possible diffuse gastric carcinoma or possible syphilis of the stomach. Since admission to the station hospital the patient had lost about twenty-five pounds in weight. He frequently had chills followed by elevation of temperature and profuse perspiration; he stated that he felt cold. Clinical Findings (Captain Magnes): On examination, on Oct. 16, 1943, at Winter General Hospital, the patient appeared pale and weak. He moved slowly in bed as if he were in pain. On breathing, the lower right chest and upper right abdomen showed splinting; the upper abdomen seemed slightly distended. The lungs and heart were normal. There was rigidity of the upper portion of the right rectus muscle on palpation, and below the xiphoid process on both sides a tender mass was palpable. This seemed more marked on the right and extended about 4 inches below the xiphoid process. The entire liver was enlarged about 2 inches below the costal margin. Laboratory Findings (Oct. 18): Red blood cells, 4,300,000; white blood cells, 10,000; hemoglobin, 13.8 gm. Occult blood in the feces, 3+. Total gastric acidity, 49.0; free hydrochloric acid, 45.0; no lactic acid. Van den Bergh test: direct, none; indirect, 0.47 mg. Urine negative. Roentgen Findings (Major Pomeranz): Radiographic and fluoroscopic study (Oct. 19) showed an orthotonic stomach of fair size, definite hypersecretion, good peristalsis throughout, and no defects. The duodenal cap showed no defects. The liver was enlarged. Fluoroscopic observation, in the prone right oblique position, showed a semicircular, faint linear extension of barium near the superior portion of the duodenum.

Blood Histamine in Gastric Cancer and Peptic Ulcer

SummaryBlood histamine is within normal limits in patients with gastric carcinoma and with peptic ulcer. There is no relationship between blood histamine and the presence or absence of free hydrochloric acid in the stomach.Blood histamine in man is carried chiefly by granulocytes, but is not directly related to the number of granulocytes in the blood.

NUTRITIONAL ANEMIA IN AN INFANT RESPONDING TO PURIFIED LIVER EXTRACT

Macrocytic hyperchromic anemia in infancy is infrequently observed. Faber¹and Bachman²have reviewed 19 previously reported cases. Langmead and Doniach³recorded an additional case. Macrocytic hyperchromic anemia in infancy usually is observed in previously healthy infants after an infection of the upper respiratory tract followed by a period of vomiting or diarrhea or both. The patients are noticeably malnourished and fail to gain weight in spite of changes in formulas and addition of various vitamins to the diet. Free hydrochloric acid is nearly always present in the gastric contents, although frequently decreased in amount. Administration of crude liver extract by mouth or injection has frequently been followed by reticulocytosis, rapid rise in the number of red blood cells and gain in weight. Anemia does not recur after it has once been relieved. Because of the comparative rarity of this type of anemia, the case of a child

Occurrence of Blood Group Specific Substances in Gastric Juice of Patients with Pernicious Anemia

ConclusionThe gastric juice of patients suffering from pernicious anemia contained blood group specific substances at least in the same large amounts as normal gastric juice in spite of the fact that there was no free hydrochloric acid or pepsin present in the specimens. Eleven of the 12 patients were proved to belong to the so-called secretor group, while one was a non-secretor.

The precipitability of pepsin by colloidal aluminum hydroxide

1. Colloidal aluminum hydroxide, when mixedin vitro with canine gastric juice in quantities sufficient to buffer its free hydrochloric acid completely, also removes quantitatively all the pepsin from the solution. 2. Complete removal of pepsin from gastric juice can be achieved with much smaller quantities of colloidal aluminum hydroxide if the free hydrochloric acid of the juice is buffered beforehand by sodium carbonate. 3. Colloidal aluminum hydroxide, when mixed with acid gastric juice in quantities smaller than those required for complete buffering of free hydrochloric acid in the juice, causes the formation of a characteristic protein-like precipitate, which carries down pepsin in quantities roughly proportional to the volumes of the precipitates. 4. Hydrochloric acid, in concentrations comparable with its concentrations in normal gastric juice, slowly dissolves the above precipitates and liberates pepsin. The recovery of pepsin under certain conditions is quantitative. 5. Observations on experimental animals prove that the above-described reactions can take place alsoin vivo; if colloidal aluminum hydroxide is introduced into the stomach, it exercises not only a pronounced “antacid” but also an “antipeptic” action, which may last for a considerable time after a single application.

Desalting Crude Oils

The treatment of emulsified crude oils has been a problem for years in thepetroleum industry. Until comparatively recently various methods of settlingwith and without chemicals have been used with indifferent success. Since wellshave been acidized, emulsified crudes have been produced, which addconsiderably to the need for improved methods of treatment. The presence oflarge quantities of salts in the oils from acidized wells has presented severalnew problems to the industry. The use of hydrochloric acid in well treatmentshas caused the formation of sodium, magnesium, and calcium chlorides byinteraction with the dolomitic limestones. These salts dissolve readily in thewater normally present in the oil, and they. are therefore incorporated in theemulsified oil. The crystalline salts have also been found in the oil, prevented from settling by protective films such as asphalt, resins andpetrolatum. In some instances, free hydrochloric acid has been found. The saltsmay be present in crude oil in amounts ranging from a few pounds to over 1000lb. per 1000 bbl. of oil. The transportation of these crude oils through pipe lines has led to erosiveand corrosive effects, which are a tremendous cost to the petroleum industry. During 1937, more than 1,200,000,000 bbl. of crude oil was transported throughpipe lines. Of this quantity approximately 10,000,000 bbl. was water, andconsiderably more than 50,000,000 lb. was salts. If the crude oils were treatedat the producing wells to remove the salts and water, an appreciable savingwould be possible. The treatment would not be difficult, since it has beenfound that these oils are more easily treated at the time they are producedthan after the aging and more stable emulsification that occur before theyreach the refinery. Since great costs are involved in the use of.these saltycrudes at the refinery, treated oils essentially free of salts would naturallycommand a premium. The real added costs lie in refining salt-containing crude oils. Severecorrosion of refinery equipment in both topping and cracking installations hasappeared in many refineries. T.P. 915

The effect of acetyl-b-methlyl choline (Mecholyl) on the gastric secretion in animals and in man

1. There was no outpouring of mucinous, alkaline gastric secretion in 6 rabbits after subcutaneous injections of 2 and 4 mgm. of mecholyl chloride. 2. There is no marked change in the free and total acid of the gastric contents in rabbits after these dosages but because of large amounts of solid gastric residue these figures are not wholly accurate. 3. In 3 cats no free hydrochloric acid was present in the fasting gastric specimen nor did any appear after subcutaneous injections of 2, 4 and 10 mgm. of mecholyl chloride. 4. When proper care is taken to prevent the swallowing of saliva there is no marked change in character in the gastric secretions in human subjects following the subcutaneous injection of 25 mgm. of mecholyl chloride. 5. There is in most instances a slight to marked rise in free and total acidity following such an injection. 6. There is a marked increase in flow of saliva which becomes mucinous and more alkaline. 7. The accidental swallowing of less than one-half of the saliva more than neutralizes the rise in gastric acidity and the purposeful swallowing of the entire amount is suggested as a possible therapeutic measure in cases of hyperacidity.

The effect of ephedrine on the secretion of acid by the human stomach

The effect of therapeutic doses of ephedrine sulphate (one grain, or 0.065 Gm.) was determined in three healthy male subjects. It was found that the ephedrine distinctly decreased both the total acidity and the free hydrochloric acid of the gastric juice.

Obstruction of the Third Portion of the Duodenum of Unusual Etiology

Lesions producing obstruction of the third portion of the duodenum may be classified as intraluminal, mural, and extraduodenal. Obstruction may be produced by intraluminal lesions such as ingested foreign bodies and trichobezoars. Lesions of the mural type which may be responsible for obstruction include inflammatory lesions, benign and malignant tumors, and congenital stenosis. Since the third portion of the duodenum is retroperitoneal and crosses the vertebral column, it may be easily compressed by lesions in the surrounding tissues. Therefore, a large variety of extraduodenal lesions are comprised in this group, namely, congenital bands, particularly those extending between the transverse colon and jejunum; persistence of the anterior mesogastrium; adhesions to surrounding organs which are inflamed, such as the gall bladder, stomach, or colon; lesions of the pancreas, particularly inflammation, carcinoma, or cysts; enlarged mesenteric lymph nodes, and, rarely, compression by the superior mesenteric artery in persons of asthenic habitus. Cases have been reported in which an enlarged spleen or liver, movable kidney, or abdominal aneurysm produced obstruction. The symptoms caused by obstruction of the third portion of the duodenum resemble those of pyloric obstruction. The case herein reported is one of obstruction of the third portion of the duodenum of extraduodenal nature, produced by pressure of an aneurysm of the abdominal aorta. Report of Case The patient, a white woman, aged 67 years, was admitted to the Clinic on Nov. 6, 1935, complaining of nausea and vomiting of two months duration and of loss of weight. Approximately three years previously she had first begun to have symptoms of indigestion which lasted about ten weeks. During this time she had vomited almost constantly, regardless of whether she ate or not. Once during an attack she had vomited blood. These symptoms had then gradually disappeared without any particular treatment, and the patient regained her weight and strength. About two months before her admission, the previous symptoms recurred and then gradually progressed to the point where she could retain nothing on her stomach. A month later she noticed a mass in her abdomen which she thought had gradually increased in size. On physical examination at the Clinic, the patient appeared to be well developed, but poorly nourished, weak, and obviously ill. The lungs were normal. the cardiac borders were within normal limits, and the heart beats were regular and clear. There was a palpable mass over which a faint bruit was audible, in the upper part of the abdomen, with visible, but not expansile, pulsation. The laboratory findings were as follows: urine, normal; hemoglobin, 15.9 gm. per 100 c.c.; leukocytes, 8,900 per cubic millimeter; flocculation test, negative, and total gastric acids 32 and free hydrochloric acid 16 units (Topfer's method).

PERNICIOUS ANEMIA WITH NORMAL BLOOD PICTURE

Article1 August 1935PERNICIOUS ANEMIA WITH NORMAL BLOOD PICTURECONLEY H. SANFORD, M.D., F.A.C.P.CONLEY H. SANFORD, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-9-2-189 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIt appears established, from the experiments of Castle and his co-workers,1, 2, 3that pernicious anemia is a deficiency disease due to the absence of an intrinsic factor of undetermined nature in the gastric secretion. This intrinsic factor is definitely not hydrochloric acid, though its absence is practically always associated with absence of free hydrochloric acid in the stomach contents. It is well known that this deficiency exerts its influence chiefly on the blood-forming organs and the nervous system. It is a fact, though in my opinion not uniformly appreciated by clinicians and hematologists, that these two systems may be...

STUDIES ON THE SUPRARENAL CORTEX

1. A group of experiments is reported in which bilaterally suprarenalectomized adult male dogs have been maintained in apparently normal condition over prolonged periods, up to 5 months, without the use of any suprarenal gland preparation or extract and by the administration of sodium chloride and sodium bicarbonate alone. Withdrawal of the salts then produced typical suprarenal insufficiency. 2. The relation of the absence of free hydrochloric acid in the gastric juice of suprarenalectomized animals, in addition to, or independent of the factor of dehydration, for the production of anorexia and hypoglycemia, is discussed. 3. Further evidence is presented in these experiments in support of the view that the suprarenal cortical hormone in the adult male dog is concerned with the regulation of sodium excretion by the kidney, and thus eventually with the proper maintenance of water balance in the organism. It has no direct influence on carbohydrate metabolism. 4. The reciprocal changes in the plasma concentrations of urea and of potassium which take place as the concentrations of plasma sodium and chlorides vary, are pointed out as furnishing a mechanism whereby abrupt alterations in osmotic pressure are dampened, and the volumes of fluids in extracellular and intracellular compartments more efficiently stabilized.

QUANTITATIVE STUDIES ON INCREASED POTENCY OF LIVER EXTRACT BY INCUBATION WITH NORMAL HUMAN GASTRIC JUICE

Excerpt The therapeutic effectiveness of liver and fractions of liver in the treatment of pernicious anemia is well established. Minot, Cohn, Murphy, and Lawson1demonstrated that although slight re...