THE EFFECTS OF VAGOTOMY ON THE PHYSIOLOGY OF THE STOMACH IN PATIENTS WITH PEPTIC ULCER 1

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Abstract
Studies on the secre-tory and motor function of the stomach were made on a series of patients with peptic ulcer before and after complete section of the vagus nerves to the stomach. Control studies were also made on a series of patients with other diseases. The continuous night secretion of gastric juice in the empty stomach of patients with benign ulcer was found to be greater in vol. and higher in acidity than that of patients without ulcers. This excessive continuous secretion of gastric juice was found to occur in these patients although they were shielded from the sight, odor, or taste of food, and there was no food present in the upper intestinal tract. This excessive secretion was markedly reduced following section of the vagus nerves to the stomach, thus indicating that it is neurogenic in origin. The secretory response of the fasting stomach of patients with benign ulcer to the stimulation of insulin hypoglycemia and the sham meal was abolished by section of the vagus nerves to the stomach. These tests were found to be of value in determining whether or not the vagotomy was complete. The motility of the empty stomach of patients with benign ulcer was found to be markedly reduced for at least 2 wks. following section of the vagus nerves to the stomach. It returned toward normal limits usually within a period of 1-3 mos. Following section of the vagus nerves to the stomach, the ulcers usually healed as demonstrated by x-ray examination, and with rare exceptions, the patient experienced complete, immediate, and persistent relief of ulcer pain and distress.

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