No abstract

While preparing for work on another problem it was decided to employ the histamine test of gastric secretory function as a part of the study. A search for data concerning the use of the test in children yielded only a few references and revealed the desirability of work on the subject. Literature on the histamine test in the adult is copious. According to Lee,1 the test resulted as a development of work by Dale and Richards in 1918 and of Popielski in 1920. Bockus and Bank 2 accredit Carnot, Koskowski and Liebert with the first observation regarding the effect of histamine on the human stomach. Since its introduction as a test of gastric secretory function, the histamine test has enjoyed great vogue. The enthusiasm with which the test was heralded and accepted is, no doubt, an expression of a widespread recognition of inaccuracy and inadequacy of the gastric function tests that had been employed previously. Bloomfield and Polland 3 criticized the test meal on the grounds that : ( 1 ) appetite, distaste for food, rapidity of eating and varying quantities of saliva give rise to inconstant results ;(2) the test meal is not a maximum stimulus to gastric secretion and cannot be repeated with identical results;(3) the material tested con¬ sists of a mixture of secretions and test meal, and not of gastric juice ; (4) the emptying rate of the stomach influences the results; (5) only a general idea regarding the volume of gastric juice secreted is gained. These criticisms seem to be met to a large extent by the histamine test. In adults the test has been found of great value in differentiating between pseudo-achylia and true achylia. Histamine (ß-iminazolylethylamine) is a derivative of the aminoacid histidine, which, according to Sollmann,4 occurs in all tissues.Although histamine is found in relatively large amounts in the normal gastro-intestinal tract, it is destroyed at this site and is therefore ineffec¬ tive when administered by mouth. Subcutaneous or intramuscular injec¬ tion of the drug in sufficient amount is followed by capillary dilatation, lowering of blood pressure and stimulation of many secretory glands. Excessive doses produce a condition similar to that of anaphylactic shock. Rühl,5 working with animals, found doses of 1 mg. per kilo¬ gram to produce severe myocardial damage with cardiac dilatation and increased resistance in the pulmonary circulation. Bally 6 pointed out that in the rabbit, in accordance with its known property of stimu¬ lation of smooth muscle, histamine produces a rise in blood pressure (presumably due to vasoconstriction). Rabbits dying of histamine shock show engorgement of the right side of the heart. Dobsonã dvised using the drug cautiously in cardiac and asthmatic cases because of the reported constrictive action on the bronchioles. Sollmann 4 is of the opinion that histamine is probably closely related to gastrin or secretin. Both Sollmann4 and Cushny8 stated that it stimulates the secretion of saliva and of gastric and pancreatic juices. Lim, Matheson and Schlapp,9 however,...

No abstract

No abstract

No abstract