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September 15, 1923


JAMA. 1923;81(11):904-906. doi:10.1001/jama.1923.02650110034010

Owing to the frequency of epigastric distress in gallbladder disease, the notion has crept into the minds of many medical men ( Simnitzky,1 Griffiths2 and others) that hyperacidity is apt to be an accompaniment, if not a symptom, of cholelithiasis. That an absence of free hydrochloric acid, or an achylia, more often exists does not seem to be generally recognized, although a number of articles have appeared, from time to time, calling attention to it. Leva,3 in 1893, was the first to note achylia in patients with gallstones, but the number of his cases was small and part of them so complicated that he drew no conclusions. Little is to be found in the literature following Leva's report until Glaser's 4 work in 1905. He stated that hypochlorhydria was of frequent occurrence in the patient who had presented gallstone symptoms for a long time. Hohlweg's5 reports in