Duodenal ulcer, hyperacidity and J C Adams.

Dr J C Adams (1871-1951), at the time of the award of his MD degree, 15 July 191 1. It was in 191 1 that Adams submitted his MD thesis to the Queen's University of Belfast. Regrettably, the original has now disappeared, but Baron was able to read it in 1969 and now tells us that Adams had carefully studied 20 patients with proven duodenal ulcer. Fourteen of these, including many with pyloric stenosis, had hyperchlorhydria on the evidence of Ewald test meals. Hence Moynihan's much quoted figure of 70 % for duodenal ulcer patients with hyperacidity.2 Adams then wrote 'Hyperchlorhydria . . . is a condition of congestion, hyperaesthesia and hyperacidity . . . with intervals between attacks . . . It might be that after this condition had existed for some length of time an ulcer formed. In some cases there is a continuous and copious flow of saliva which is very distressina to the patient'. Adams had thus taken much further the classic observation of Schwarz