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After a brief physiopathological introduction, the results obtained with Cimetidine in 171 cases of peptic oesophagitis are described. Given the high percentage of successes even in serious oesophagitis and the minimal incidence of side effects, cimetidine is the therapy of choice in conservative treatment of peptic oesophagitis.

Male albino rats of the Wistar strain, without food from 48 h, have been operated with pylorus ligature and treated with cimetidine, at the dose of 30 mg/kg i.m., just after the operation and 12 h later. Cimetidine reduced the size and the number of gastric ulcers induced by pylorus ligature, showing a significant protective effect. This action, due to the inhibition of gastric secretion induced by cimetidine, supports the hypothesis that the staunching of gastric juice (by pylorus ligature) plays a basic role in the pathogenesis of these experimental gastric ulcers.

On the basis of favorable results recently reported in literature with cimetidine in the prevention and therapy of upper gastrointestinal haemorrhages, the Authors have treated a patient with severe haemorrhage from acute gastric ulcer arised after jejunum-ileal massive resection for mesenteric infarction. Result was very good, with stop of haemorrhage and quickly healing of the lesion. This clinical report is of interest particularly in view of high mortality of postoperative haemorrhagic acute gastropaties with therapeutic means, medical or surgical, just now available. At last the particular physiopathological aspects of the case suggested some considerations about mechanisms of action of the Cimetidine.

Cimetidine, a non-thiourea-containing histamine H2-receptor antagonist, has been employed in the treatment of peptic ulcer. We studied 50 patients, partly with double-blind method, and partly in a free trial. Duodenal ulcers were completely healed in 80% of the cases, at the control endoscopy after a 4-week period of treatment with cimetidine (1000 mg/day). Peptic ulcer in general healed in 76% of the cases. Gastric secretion was significantly reduced after cimetidine. An important improvement in subjective symptoms was noted in every patient. No toxic effect was noted.

The topical nature of the treatment of Zollinger-Ellison syndrome arises from the alternatives to total gastrectomy, namely medical management with cimetidine, and tumorectomy. The various stages in the history of the syndrome are described with reference to a personal series of 16 cases, and various observations are made with regard to the clinical aspects of its diagnosis, treatment, and emergency surgical management. A detailed account is given of several illustrative cases. Detailed assessment of the various factors on which the current indications for surgery are based suggests that a certain degree of eclecticism should be adopted, though the results offered by total gastrectomy must be regarded as sound in the long term.

The Authors have studied the clinical employment of cimetidine. After the discussion of data is demonstrated the rapidity and helpfulness of this therapy in order to the other specific drugs.

The Authors report on 85 patients hospitalized in the resuscitation department, suffering from serious acute conditions and treated prophylactically with cimetidine. In comparison with analogous group of not treated patients, a marked diminution of digestive bleeding complications, typical in these patients, was noted.

The effectiveness of Cimetidine in preventing complications, like acute pancreatitis and hemorrhagic gastritis, after operations on Vater papilla (ISP) is studied. In patients treated with Cimetidine the volume of nasogastric secretion was smaller and diastasemia and diastasuria treated values returned to the normal range earlier than in non-treated patients. In the latter group a case of pancreatitis and one of post-operative hemorrhagic gastritis were found. The treated patients, instead, did not suffer these complications. It was concluded that Cimetidine after IPS is useful, because it complies with the request that determined its employ.

40 patients with an endoscopic diagnosis of bleeding gastric or duodenal lesions have been examined in a double blind study. The haemorrhages were subdivided into slight and serious on the basis of objective parameters. Cimetidine (1.2 g/die i.v.) or placebo in a preparation indistinguishable from the drug were administered to patients. Arrest of the haemorrhage was evaluated on the basis of clinical and endoscopic criteria, and the study was pursued up to 96 hours from the start of bleeding. The effect of cimetidine proved greater than that of the placebo in serious haemorrhage, particularly where due to gastric lesions, but no differences were seen between drug and placebo in the slight haemorrhages.

A between-patients trial between a new anti-hypertensive drug (Guanabenz) and methyldopa in subjects with essential hypertension showed the new preparation to be active and endowed with a satisfactory therapeutic index.

The anti-hypertensive action of 2,6-dichlorobenzylideneaminoguanidine acetate (BR 750) is described. Inter-patient comparison pointed out its excellent tolerance, together with an anti-hypertensive activity at least equal to that of alpha-methyldopa.

A research group led by L. Businco between 1937 and 1942 was able, by applying new measuring methods in a variety of experimental situations, to demonstrate for the first time a concrete pathogenetic link between histamine and gastroduodenal ulcer. These personal researches produced the following objective data: increase in blood histamine in more than 70% of patients with ulcers; presence of histamine in the gastric juice of ulcer patients; diminution of blood histamine after gastric resection; increase in blood histamine in patients with postoperative peptic ulcer; increase in tissue histamine in ulcerous zones; diminution in blood histamine, parallel clinical improvement and contemporaneous diminution in total and hydrochloric acidity in patients treated with histaminase. The discover by Black et al of cimetidine as an antagonist of H2 receptors to which is added the gastric secretory stimulus of histamine, underscores the role played by this substance in determining gastroduodenal ulcer.