Achlorhydria Killed A Person

No reference has been found to a controlled study of the effect of administering both hydrochloric acid and pepsin in cases of achlorhydria. Some difficulties in the interpretation of results have been pointed out and the suggestion made that neutralization may be unimportant in the production of the condition. A patient with achlorhydria has been studied by fractional meal tests to determine the effect of giving acid and pepsin. These substances have been administered, combined and separately in varied dosage, single or fractional and at different times in relation to meals. A few days after the administration had been begun there were evidences that secretion had increased and after thirteen days free hydrochloric acid and pepsin in fair concentration were found in the stomach spontaneously after a test-meal. In the analysis of the various factors involved in the increase of secretion it has been felt that the ingested acid played a part. The suggestion made by former investigators that it may have a stimulating effect on gastric secretion has, therefore, been revived, and suggestions for the treatment of achlorhydria have been made. The pepsin extracts gastron and essence of pepsin have been subjected to a laboratory investigation and the former has been used clinically. Several points regarding the behavior of pepsin have been illustrated but the use of pepsin preparations in cases of achlorhydria has seemed unimportant in comparison with the need for acid. It was possible to increase the pepsin content of the stomach but intragastric pepsin has been shown to be inactive in the absence of free acid. He did not survive to see the light.