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Optimal conditions for ulcer production in the pylorus-ligated mouse seem to be the following: the use of animals between 9 and 11 weeks of age, a preoperative starvation period of 15 hours, an experimental period of 8 hours, and an ambient temperature of 28℃. Under these conditions, ulcers are produced in nearly all animals. It appears that gastric acidity in ulcer formation in the mouse may be secondary to gastric distention and interference with circulation. Submitted on December 1, 1958

Gastric distention and age appear to play a role in ulcer formation in the pylorus-ligated mouse. For this reason, distensibility of the stomach of albino Swiss male Rockland R. A. P. mice was investigated. The excised stomach was ligated at the pylorus and saline was injected slowly through a tube in the esophagus. Pressure and maximum volume of saline used to reach the breaking point were determined. Most perforations occurred in the glandular stomach. Gastric perforations in young mice were produced with considerably less pressure and smaller volumes of saline than in older animals. These results may explain previous observations on age differences in ulcer formation and mechanical gastric perforation in the pylorus-ligated mouse. A possible relation between intragastric pressure, circulation and ulceration, is discussed.

Postoperative vomiting of a regurgitant type, first mucous, then bilious, finally brown, grumous and bloody, has been for many years a well known and much dreaded sequel of surgery, and has struck terror to the hearts of many surgeons after the performance of apparently simple and successful operations. The significance was so evident and a fatal result was so often inevitable as to dishearten the most buoyant optimist. Accompanied by slight icterus, relative or absolute suppression of urine, intestinal and gastric distention, tympanites and aperistalsis, it constitutes a pathologic picture long known and dreaded, yet little understood. ETIOLOGY. It is only within the last year or two that the true causes which have produced this symptom complex have been generally suspected and a solution of the problem seriously suggested. Even now when we seem to have struck the right lead, little has been done other than to suggest in an

Gastric dilatation may be the result of organic obstruction or may occur as an acute "functional" phenomenon.In the vast majority of patients both the presence and nature of the gastric dilatation are easily determined by clinical and roentgenologic means.Occasionally, marked dilatation of the stomach gives rise to a diagnostic and/or management problem. Some illustrative examples of such cases are presented. These include partial gastric volvulus secondary to transdiaphragmatic herniation of the transverse colon through the foramen of Morgagni, massive gastric distention simulating ascites and obstruction at the esophago-gastric junction associated with gross distention of the stomach.

The effect of distention of the stomach on pancreatic secretion was studied in conscious dogs which had chronic pancreatic fistulae. The results obtained are given. a) In 37 experiments on 23 dogs the average rate of pancreatic secretion was 1.7 cc/20 minutes, while after inflation of a condom in the stomach with 250–400 cc of air the secretion increased in every dog to an average of 4.2 cc/20 minutes (147% change). This was accompanied by an increase in protein production of 98.7%. In five dogs receiving maximal stimulus from continuous secretin, there was a further rise in volume and protein following gastric distention. b) Subcutaneous transplants of the pancreas responsed to secretin but not to gastric distention. c) Distention of four total innervated gastric pouches produced the same increase in volume and protein as distention of intact stomachs. d) Increased secretion was not observed after distention in vagotomized or atropinized dogs or dogs with procaine block of the vagus in the neck. e) An increase in rate of secretion and protein occurred after distention of the stomach in two human subjects with pancreatic fistulae.

Previous assessment methods of gastric interoception either rely on self-reports, or imply invasive procedures. We investigated the reliability of startle methodology as a non-invasive alternative for the assessment of afferent gastric signals. Twenty-four participants were tested on three separate days, on which they were requested to ingest water (either 0, 300 or 600 ml), after 8 h of fasting. On each assessment day, eye blink responses (EMG) to 10 acoustic startle stimuli (105 dB) were assessed at 4 measurement points (before, 0, 7, 14 min. after ingestion). Increased normogastric responses (EGG), ratings of satiety and fullness, and higher heart rate variability (RMSSD) suggested effective non-invasive induction of gastric distention. Startle responses were lower directly after ingestion of 600 ml as compared to earlier and later measurements. These results suggest that startle methodology provides a reliable method to investigate afferent gastric signals. It could be useful to study possible dissociations between subjective reports and objective afferent gastric signals in eating or somatoform disorders.

To the Editor: —I note the interesting communication of Dr. H. T. Summersgill (The Journal, July 12, p. 139), regarding the use of barium sulphate and malted milk. in gastro-intestinal roentgenography. I have also noticed the condition in several instances. It is true, however, that I have not noticed the extremely severe after-effects which Dr. Summersgill has reported. In the cases I have observed, there was a marked gastric distention, which was followed by nausea and belching, and, in one case, by vomiting. This was followed by severe diarrhea, which lasted about twenty-four hours. Later, I tried giving another barium meal to two of these patients. In one case, I used buttermilk as the base; and in the other, a mucilage of acacia formula. There was absolutely no difficulty experienced following these mixtures. Since then I have not attempted the use of malted milk in those cases which exhibit emaciation