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MORE ABOUT VAGOTOMY

MORRIS KESILMAN, M.D.
JAMA. 1948;137(2):211. doi:10.1001/jama.1948.02890360093021.
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ABSTRACT

To the Editor:—  I cannot agree with your comment in its entirety, specifically where you state that Dragstedt claims that the vagotomized stomach will secrete in response to insulin stimulation. In the November 1947 issue of Annals of Surgery, page 687, he makes the following statement:In these 160 patients, the vagus section was complete in 142 cases as evidenced by a reduction in the night secretion of gastric juice, a decrease of over 60 per cent in the total hydrochloric output from the stomach, and a negative secretory response to insulin hypoglycemia.On page 688 he summarizes the case histories of 2 patients who had recurrences after vagotomy and in whom the insulin test was positive, indicating that the vagotomy had been incomplete. These patients were reoperated on and in each, the remaining vagus fiber was found and sectioned, after which the test became negative. A protein meal invokes

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