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ARTICLE |

TOXIC MANIFESTATIONS FOLLOWING THE ALKALINE TREATMENT OF PEPTIC ULCER

LEO L. HARDT, M.D.; ANDREW B. RIVERS, M.D.
Arch Intern Med (Chic). 1923;31(2):171-180. doi:10.1001/archinte.1923.00110140023003.
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Sippy1 has attributed the chronicity of ulcer to the corrosive action of gastric juice, and on this basis administered small amounts of alkali to the patient hourly, over a long period (from three to four weeks in the hospital and several weeks afterward). By a combination of powders—calcium carbonate, magnesium oxid, sodium bicarbonate and bismuth subcarbonate—in varying proportions, he was able completely to neutralize the gastric juice, and thereby to promote healing of the ulcer. He says, "It may be helpful to know that in rare instances it has required the equivalent of 30 grains (2 gm.) each of calcium carbonate and sodium bicarbonate, every hour, midway between feedings and every half hour after the last feeding until 9 p. m. to control the free acidity." He does not, however, discuss a certain group of cases in which it is difficult and almost impossible to control the acidity. It has

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