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Article
December 8, 1928

THE CLINICAL SIGNIFICANCE OF PRIMARY ACHLORHYDRIA

Author Affiliations

MINNEAPOLIS

From the Department of Medicine, the Nicollet Clinic.

JAMA. 1928;91(23):1763-1768. doi:10.1001/jama.1928.02700230003002
Abstract

The ninety-three cases of achlorhydria studied between February, 1921, and February, 1928, can be broadly classified as primary and secondary. The causes that may operate to produce a secondary achlorhydria are chronic cholecystitis, gastric carcinoma, gastric syphilis, alcoholism, old age (arteriosclerosis), chronic upper respiratory infection (sinusitis, tonsillitis, bronchitis), mouth infection (caries and pyorrhea), pregnancy, toxic goiter, myxedema and tuberculosis (both pulmonary and intestinal). Achlorhydria is also found often enough in certain other conditions, such as migraine,

allergic conditions and skin diseases (acne rosacea, scleroderma), to make a direct relationship rather certain. There are a number of persons without free hydrochloric acid in the gastric secretions in whom none of these etiologic factors are demonstrable. In our records, forty-two cases were found which fell under some one of the foregoing classifications. Chronic cholecystitis and carcinoma of the stomach were not included, since the absence of acid in the former is rather

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