A Study of the Effect of Insulin on Gastric Motility.

In continuing the study of the mechanism of pain in gastric and duodenal ulcer a method for increasing the gastric motility was desired. Bulatoa and Carlson 1 showed that the injection of insulin into normal fasting dogs increased the motility of the stomach. Quigley, Johnson and Solomon 2 concluded from their investigations that the same held true for the stomach of normal fasting man. Clinicians have frequently observed hunger as a symptom of the so-called “insulin reaction”. Hence it was assumed that the hunger so seen was due to the increased gastric motility, Carlson 2 having correlated “hunger pangs” with activity of the stomach.

This report is based on the results of 18 experiments done on 13 patients, 11 of whom had duodenal ulcer, 1 paroxysmal fibrillation, and 1 mild diabetes mellitus. The last 2 had a complete achylia to the histamine test. Kymographic records of gastric activity were made by means of the usual single balloon method connected to a water manometer, the entire system being inflated with 150 cc. of air. In a number of cases the position was checked by fluoroscopic examination. The tracings were all made with the balloon in the pyloric region of the stomach. Fasting periods ranged from 14 to 21 hours; the average time was 19 hours. The patients were instructed to register the appearance of “hunger pangs” by means of closing a switch set in series with a signal magnet.

In most instances control tracings had been obtained during previous experiments of a different nature. With those in which this had not been done, a preliminary period was recorded before the administration of insulin.

Insulin (Mulford) was given subcutaneously in doses of 8 to 20 units.