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THE MECHANISM OF PAIN IN GASTRIC AND IN DUODENAL ULCER:  II. THE PRODUCTION OF PAIN BY MEANS OF CHEMICAL IRRITANTS

WALTER LINCOLN PALMER, M.D.
Arch Intern Med (Chic). 1926;38(6):694-707. doi:10.1001/archinte.1926.00120300011002.
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Experimental data are presented here regarding the rôle of chemical irritants in the production of ulcer distress. Gastric ulcer and duodenal are considered together because the mechanism of pain in each has been found to be essentially the same.

LITERATURE  The older clinicians, like Talma1 and Riegel,2 apparently felt that the pain of uncomplicated ulcer was in some way related to the acidity of the gastric content, but they recognized gastric peristalsis and coarse food as possible additional factors. These men debated, not the mechanism of ulcer pain, but rather the occurrence of pain from hyperacidity without a definite organic lesion. Lowenthal,3 Schmidt,4 Boring5 and Hurst6 introduced various amounts of hydrochloric acid into the stomach in strengths varying from 0.5 to 2 per cent. They failed to produce pain either in normal persons or in patients with ulcer. Hardt7 reported that distress caused by ulcer might even be relieved by

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