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Milton J. Matzner, M.D.; Charles Windwer, M.D.
JAMA. 1937;108(6):492. doi:10.1001/jama.1937.02780060058024.
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To the Editor:—  In an editorial in The Journal, Dec. 19, 1936, the important relationship of gastric acidity to experimental ulcer in animals, as well as gastric and duodenal ulcer in man, seems to have been definitely shown. However, the statement "within wide limits the concentration of pepsin appears to be of no importance" justifies further discussion. Recent clinical observations of Vanzant, Osterberg, Alvarez and Rivers (J. Clin. Investigation12:557 [May] 1933) confirmed by Mullins and Flood (ibid.14:793 [Nov.] 1935) seem to indicate that peptic ulcer in man is frequently accompanied by an increase of pepsin as well as of acidity.Animal experimentation likewise points to the probable important rôle of pepsin in the pathogenesis of ulcer. Howes, Flood and Mullins (Surg., Gynec. & Obst.62:149 [Feb.] 1936) reported that operatively produced gastric defects in cats showed a greater delay in healing in those receiving pepsin


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