The Hospital Bulletin, Vol. V, No. 3, May 15, 1909

by Various

DISCUSSION BY DR. WARNER HOLT, OF WASHINGTON, OF THE PAPER ON THE CHEMICAL CO-RELATION BETWEEN THE SALIVARY GLANDS AND THE STOMACH, BY JOHN C. HEMMETER, OF BALTIMORE.

Read Before the Society for Experimental Biology and Medicine, of New York, Meeting in the Rockefeller Institute for Medical Research, on December 16, 1908.

Dr. Holt said in part: “This experimental study by Dr. Hemmeter is not, as it might appear to be, only an inquiry into the physiology of a limited part of the digestive apparatus, but it is an attempt to solve a biologic problem and to get at the broad basic principles that underlie the chemical co-relation of the organs.

“When a worker occupies himself with the effect of the extirpation of one organ of digestion upon the organs in the next segment of the digestive apparatus, he naturally thinks of phenomena of exclusion or loss of function in one or the other of the segments following the one extirpated, but instead of phenomena of exclusion it is conceivable that those of exaggerated activity in the other segments of the digestive tube might result.

“For 'a priori' we cannot know whether the influence that one segment of the digestive tract exerts upon the succeeding segment is that of stimulation or of inhibition, or of both, viz., of stimulation under one set of conditions and inhibition under another set of conditions. In the investigation of the problem of a chemical co-relation between the salivary glands and the stomach, Dr. Hemmeter has done meritorious work, a great part of which it has been my good fortune to observe and assist in personally; though I am a physician in the employment of the government at Washington, I consider myself a post-graduate student of Professor Hemmeter. I have seen personally four of his animals that had successfully been nursed through the Pawlow operation and extirpation of the salivary glands after months of the most trying work. It required a great deal of perseverance to persist in this kind of work, especially when some of the best animals that had emerged safely from the vicissitudes of the operation for an accessory stomach and from the removal of all the salivary glands on one side of the head succumbed to the third operation in the attempt to remove the remaining salivary glands on the other side.

“The history of these operative failures, though they will never be told, constitute a large part of the merit of those who have worked with Dr. Hemmeter in this research. No matter what the final outcome of the future investigation of this problem will be, whether affirmative or negative, the intrinsic value of such work will be appreciated by all who are to the least degree conversant with the history of physiology. Nowadays we are too liable to forget the hard plodders in experimental work who have started the solution of a problem, and when the last word has been said the worker of the beginning is generally forgotten.

“In this connection I desire to quote an expression of Prof. William H. Welch concerning the merit of the work of ex-Surgeon General Sternberg, done since the first Yellow Fever Commission was appointed, in 1879 (see Medical News. June 21, 1902. p. 1198). Dr. Welch said 'that Sternberg's work with yellow fever would stand forever; that it was a common thing in these busy days to forget the steps which led up to an important discovery. All that Dr. Sternberg had done in the study of yellow fever was necessary work, and it had to be done just in the way that he did it. The ground had first to be cleared. If it were not so, the discovery had not been possible; and later discoverers themselves would have had to hunt out the large host of microorganisms which Dr. Sternberg had described and laid aside.'

“And similarly I can say of Dr. Hemmeter's efforts that, no matter what the eventual outcome of this problem will be, all that he has done was necessary work, and it had to be done just in the way that he did it.

“Just one more idea and I shall have finished. It concerns the demonstration of such research work in places at a distance from the experimentor's laboratory. Such demonstrations are always attended with great difficulty. They usually require four animals, two or three janitors to transport them, and as many laboratory assistants as the director of the laboratory can manage to take with him. The technique of these operations, the high-grade sensitiveness of operated animals, the refinement with which chemical tests should be made, all require for their safe conduct that the experimentor should work only with those men who are used to his system. The animals themselves are always influenced in one way or other by the presence of strangers. I remember in one animal which was demonstrated on March 17th, at the University Hospital, the demonstration at which Dr. Satterthwaite was present, a most unexpected change in the quality of the gastric secretions took place. This was a control animal which had undergone no operation whatever. He was simply taken along to show the proteolytic power of a normal dog and compare it with the operated dogs. His gastric juice had been previously tested on several occasions, and always found to be of regular standard, but on the night of the demonstration before the Medical Society this animal's gastric juice was practically inactive, containing no HCL nor pepsin.

“Dr. Hemmeter has already informed you that in some animals the loss of gastric juice after extirpation of the salivary glands is only temporary, and that in varying time—in some cases three weeks, in other animals three to four months—there is a gradual resumption of gastric secretion. This resumed secretion, however, never becomes as effective as it was in the same dog before an operation. The question when to begin to make observations on an operated animal depends entirely upon the state of this animal; if the dog eats his food with appetite, he has no fever, and his digestion appears to be satisfactory; then the observations may be begun, even if it is only one week or ten days after the last operation. One of the most valuable animals that was used in this series of experiments was so injured in the effort to transport him to another laboratory that he could not be used for further experimentation. The dog struggled so in his holder while he was being transported in a wagon that the partition of true mucosa which separates the accessory from the plain stomach was broken through. This had happened once before in transporting a dog from the laboratory to Dr. Hemmeter's country place, and his associates in the Medical Faculty, becoming aware of the great labor and cost involved in such operations, and the rarity with which they succeed, advised that no further Pawlow dogs be sent to other laboratories.”