Licence: Public Domain Mark
Credit: The diseases of the stomach / by Dr. C.A. Ewald. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
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![cliloric acid was only present 7 times; mucus, bile, peptones, and pepsin were occasionally found. The cause of the presence of this fluid must be the saliva and pharyngeal secretions which are swallowed during sleep. He concludes that the presence of hyperacid fluid in amounts over 50 c. c. is pathological.] Test Meals.—For testing the functions of the stomach we give the patients various meals, some of which are simple, others are larger; but, so far as possible, the various meals should be uni- formly prepared. The test hreakfast {Probefruhstuck) of Ewald and Boas consists of an ordinary dry roll and a definite quantity— ^ litre [f^x]—of fluid, either simply warm water or weak tea [without milk or sugar]. (Tea sometimes has a feeble acid reac- tion, depending on the province from which the tea leaves come.) According to Konig's analysis, such rolls contain 7 per cent nitro- gen, 0*5 per cent fat, 4 per cent sugar, and 52*5 per cent non- nitrogenous extractive substances, to which 1 per cent ash must be added. The roll is thus a mixture of the various nutritious ingre- dients, and is made up here [Berlin] of a tolerably uniform weight, about 35 grammes [540 grains]. The test breakfast thus includes albuminoids, sugar, starches, non-nitrogenous extractives, and also salts; the tea belongs to that group of foods which are of consid- erable importance to the gastric secretion. By means, of this breakfast we can offer the stomach all the ingredients which are usually taken, with the great advantage that they are liquefied in a relatively short time, or at least they are softened sufiiciently to permit their passage through the tube; while if solid food like meat is given, the openings in the tube are very easily plugged. This also explains why many can not dispense with the stomach purnp, which naturally gives greater suction power. The test breakfast can be taken by most patients with gastric disorders, many of whom would be unable to eat a larger meal. My method has the additional advantage of great cleanliness. Even should the patient vomit, as occurs occasionally in a very few cases, the vomit does not consist of fatty, offensive, and viscous masses, as when a large meal is taken, but only of comparatively clean morsels of bread. These advantages have caused the method to be very popu-](https://iiif.wellcomecollection.org/image/b21223026_0035.jp2/full/800%2C/0/default.jpg)
