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December 15, 1917


JAMA. 1917;LXIX(24):2018-2024. doi:10.1001/jama.1917.02590510010006

Digestion seems to suffer very little from disturbances of secretion. Many physicians have commented on the fact that we often discover achylia gastrica accidentally in patients who have no complaint to make about their digestion. The great obstacle to making an early diagnosis of cancer of the stomach is the fact that although the mucous membrane may be almost or entirely gone, these patients ordinarily have no symptoms until the growth is large enough to block the pylorus. They will then have trouble until a channel sloughs through the tumor, after which they may be perfectly comfortable again. Similarly, there may be no complaint of indigestion after extensive resection of the bowel. Men have lived in comfort, except for an occasional diarrhea, after removal of one half of the small intestine. As Taylor1 has aptly said, we seem to have "duplicate plants" for chemical digestion. If pepsin fails, the