ALIMENTARY AZOTEMIA AND THE BLEEDING PEPTIC ULCER SYNDROME

Since 1933, when Sanguinetti¹ first called attention to increased amounts of urea nitrogen in the blood of patients with bleeding peptic ulcer, this observation has been confirmed by many writers. These include Sanguinetti himself² (1933), Christiansen³ (1935, 1936, 1937), Ingegno⁴ (1935), Meyler⁵ (1935, 1936), Sučić⁶ (1935), Alsted⁷ (1936), Borst⁸ (1936, 1938), Clausen⁹ (1936) and Polack¹⁰ (1936). There have been at least sixteen other reports during the past five years; these will be quoted later. Although this syndrome has apparently been recognized over a period of only eight years, it is of considerable importance. The time has come to take stock and to appraise the significance, cause and mechanism of this syndrome.

SIGNIFICANCE OF AZOTEMIA  In some early studies the opinion was expressed that renal or hepatic damage was the cause of the elevation in urea nitrogen content of the blood