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tion of the production of secretin in the duodenum. why should not, clinically, a large number of dys- pepsias be secondary to a disturbance in the highly specialized function of the duodenal mucosa.'' When it is remembered," he continues, "'that secretin also possesses an incontestable influence upon intestinal motility, one of the first and most constant signs of .secretin insufficiency must with- out doubt be clinically represented by constipation. Thus, g-uided by our experimental research, we have found a means of stimulating this function in certain constipated Dilantin 500 Mg dyspeptics." Enriquez Dilantin 1 G pre- pared keratin coated capsules of gluten, containing an active and harmless acid (tartaric), which was proved experimentally to be stable in the stomach and easily destroyed in the Dilantin Ex duodenum. The Dilantin 400 Mg results of this form of medication were most interesting. All the patients showed a more or less noticeable constipation, and in seven of the cases it was the dominating symptom, Dilantin 230 Mg inconven- iencing the patients as much by its persistence as by its obstinacy. In these seven cases acid meclica- tion of the duodenum brought about, with varying ease, according to the dose, a stimulation of the secretory and motor functions of the intestine and a regulation of the stools. Two cases were of .special interest. One was that of a person suffer- ing from localized sclerosis {"sclerose en plaques") for many years, with intractable constipated periods lasting from six to eight days, and which resisted all kinds of jmrgatives, enemas Dilantin Xr only hav- ing any action. Under this treatment the stools were immediately regulated, giving way again to constipation as soon as the treatment ceased, this occurring several times. In five of the observa- tions mucomembranous colitis was complicated alternately with constipation and painful abdominal crises, terminating by the passage of glairy mucous and membranous Dilantin 130 Mg casts. In four of the cases the colitic symptoms were nuich relieved at the same time as the constipation. Of course, the principal value of the method of treatment outlined above depends upon the pro- duction of secretin. There may be cases in which the duodenal cells will not be stimulated, and here it would seem that secretin itself could be used to good advantage. I have personaly noticed, and my experience has been confirmed by several corre- spondents, that the administration of preparations of secretin is followed quite Dilantin 330 Mg constantly by the relief of fermentation and flatulence in the upper bowel, and the reason for this is not far to seek. The principrd cause of gastric and intestinal fermenta- tions is a deficiency in the amount and activitv of the digestive juices. It has long been known that the administration of hydrochloric acid not only favors the digestive action in the stomach, but also tends to increase the amount of pancreatic fer- ments in the duodenum, and only since the discov- ery of sccreiin has ii been clear how this is brought about. \'ery little clinical work seems to have been done with secretin in Dilantin 150 Mg the United States. The only article' referring to a secretin preparation that I iiave been able to find is from the pen of Board- man Reed f 21 ). In this article he compares his stand- ard pejisin hydrochloric mixtures, Dilantin Pharmacology referred to in his excellent Ixxik.^ with an elixir containing gas- tric and pancreatic Dilantin 30 Mg secretins, and finds that these organic principles are considerably more active, rapidly bringing the work of the stomach to the normal, and, usually, at the same time improving the intestinal indigestion and assimilation. Dilantin 125 Reed states that secretogen is apparently the most pow- erful excitant of gastrointestinal secretion so far tried by him, and refers to a number of cases, one of which is mentioned in an addendum to his paper, which follows: "Since the foregoing was written I have examined chemically the stomach contents of one of the patients referred to, in which none of the secretogen has been taken for a month, and the proportions of both the free and combined hydrochloric acid were found still a little above normal, though, before the remedy was taken, there had been no free hydrochloric acid at all, and the Too Much Dilantin proportions of both the combined hydrochloric acid, and of the total acidity, had been decidedly below normal." Moore (22) of the Biochemical Department of Liverpool University, has called attention to deficient secretin production in cancer and gastric cancer. It is well known that achlorhydria is an almost constant s^'mptom of this disease, and the lack of hydrochloric acid — Cheap Dilantin the physiological stimulus to nor- mal secretin production in the duodenal walls — re- sults in a marked decrease in the amount and effec- tiveness Dilantin 50 Mg of pancreatic ferments. This nearly suf- fices to account for the nutritional disorders which are pathognomonic of carcinoma. With the fore- going in mind, it can be readily appreciated that secretin may be used in cancer and cachexias gen- erally, not to influence the disease per se, but rather as a means of increasing the digestive activ- ities and nutrition. The same ideas naturally hold good in other conditions where toxemia, superfunc- tion, or asthenia, has lessened the digestive capacity. In no disease is this influence more de- sirable than 'm tuberculosis, and attention is already being turned to the possibilities of this new ad- junct remedy for tuberculosis (23). Secretin has been recommended as a means of treating diabetes, and much was expected from its use because several very good results occasionally followed its early administration in Dilantin 200 Mg this disease. The basis of this study was the clear physiological evidence of a connection between pancreatic activ- itv and diabetes, as well as between secretin and |iancreatic activity, and that where functional dis- order of the pancreas was present advantage might be expected to follow the stimulus caused bv secretin. In their first communication on this sub- ject, Moore, Edie, and Abram (24), Dilantin 350 Mg described three cases of diabetes in which improvement follow^ed 'The writer has drawn special attention to the possibilities Dilantin 600 Mg of secretin as a Dilantin 250 Mg factor in the control of the summer indigestions of infants (20).

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