The interdependence of gastric secretion and the CO₂ content of the blood

Abstract

FOR some years sporadic indications have appeared in the literature that there is a relation between blood C02 content and gastric secretion. Maly's theory, first advanced in 1878, postulated the importance of C02 in the formation of hydrochloric acid, only, however, secondarily to NaH2PO4 which he believed to be the compound directly concerned in the formation of HCl. F. DeIhougne [1927] found a decreased acidity in response to the alcohol test meal when the subjects hyperventilated. He found, however, an increase in the C02 combining power of the blood under these conditions, which makes the effectiveness of the hyperventilation doubtful. Bakaltschuk [1928] demonstrated an increase in gastric acidity in human subjects after the inhalation of C02. An increase was also obtained by Apperley and Semmens [1928] after the rebreathing of the subject's own expired air. In a different type of experiment Szilard [1930] showed an augmented "fasting" secretion following intravenous injection of NaHCO3; the injection of glucose on the other hand caused no such rise. Numerous authors have observed that feeding large quantities of NaHCO3 over prolonged periods of time raises the level of the acid curve during fractional test meals [Li no is si e r and Lemoine, 1894; Crohn, 1918]. The ingestion of sodium bicarbonate by patients on a Sippy diet in a large number of cases increases the C02 content of the blood [Hardt and Rivers, 1923; Koehler, 1927; Gatewood and others, 1928]. Working on dogs, Boyd [1924] observed that, in small doses, sodium bicarbonate tends to increase gastric secretion. Apperly and Semmens [1928] showed, in human subjects, that there was a parallelism between blood bicarbonate con.tent and the response to a standard test meal. They attributed this to a common effect of variation in oxygenation of the blood on both gastric secretion and blood bicarbonate content. Apperly and Crabtree [1931] in a very recent article are cognizant of the above sources of error (as indeed were Apperly and Semmens), and believe that they have taken them into account. In this article, they report a direct relation between the concentration of gastric hydrochloric acid and the plasma bicarbonate content.In 1929, during an experimental investigation of the production of gastric secretion by vagal stimulation in dogs [Vineberg, 1931], it was observed that secretion was not obtained following excessive artificial respiration, but commenced shortly after the cessation of hyperventilation. The experiments reported in this paper were undertaken in an attempt to elucidate these results. In a preliminary report of this investigation [Vineberg and Browne, 1931] the conclusion at which we arrived was that a definite interdependence existed between the CO2 content of arterial blood and the character of gastric secretion.METHODS. Dogs ranging in weight from 8 to 25 kg. were employed. All animals were fed meat and porridge for 3 days, and milk only for the 24 hours immediately preceding the operation. Anesthesia was induced by means of...

Vago‐vagal reflex effects on gastric and pancreatic secretion and gastro‐intestinal motility

“…All the animals were receiving artificial respiration, and the pump stroke was adjusted until the animals were just attempting to breathe. Nevertheless, some of them may have been overventilated, with a consequent reduction in the responsiveness of the oxyntic cells to vagal stimulation (Browne & Vineberg, 1932). Some of the pepsin recovered in the gastric contents after stimulation may have accumulated in the glandular tubules during the pre-operative fasting period and been washed out by the flow of acid, but there are several reasons for regarding the increases in pepsin after afferent stimulation as evidence of a real secretion by the chief cells of the glands.…”

The gastric secretion of pepsin in man

“…In dogs with innervated gastric pouches, this has been demonstrated by direct stimulation of the vagus nerves in the neck (Browne and Vineberg, 1932;Vineberg, 1933); in man, insulin-induced hypoglycaemia has been used to effect central excitation of the vagus nerves which in turn stimulated a gastric acid and pepsin secretory response (Ihre, 1938;Chinn, Book, and Beams, 1951;Janowitz and Hollander, 1952;Harrower, Brook, and Cooper, 1956). In contrast to our increasing knowledge of the effect of surgical vagotomy on acid secretion by the stomach little is known of its effect on spontaneous pepsin secretion.…”

Studies in a Case of `Renal Rickets'

“…It is important to try and distinguish the two types of underlying renal lesion, as the prognosis is reasonably good in some pure tubular lesions if alkali and vitamin D are given. Massive doses of the latter have been suggested as a means of increasing calcium absorption from the gut, lessening the negative calcium balance and reversing the skeletal changes in hyperparathyroidism secondary to renal acidosis without glomerular insufficiency, the rationale being the lowered gastric acidity and poor calcium absorption in acidosis described by Browne and Vineberg in 1932. It would have been of little avail in the present case.…”