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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![lar. On tlie other hand, it must not be forgotten that such a mod- erate meal makes a very slight demand on the action of the viscus, and a stomach which may prove capable of digesting this moderate meal may not secrete enough for a more complicated diet. This objection apphes also to the meal of milk and bread which has been proposed by Klemperer,* and with even greater force to the one- sided administration of small quantities of albumen only (the whites of one or two hard-boiled eggs), as proposed by Jaworski. It is for this reason that I deny the value of such a meal to test all the digestive functions of the stomach. If we have given the test breakfast, and still desire to apply severer tests, nothing forbids the use of another kind of food to ascertain whether the latter is also properly digested, f Larger meals, like the test dinner {Probemittaghrod), to be taken at noon, have been employed by other observers (Leube, Kiegel, Germain See). The test dinner consists of an ordinary [German] midday meal of bouillon, barley or flour soup, a moder- ate piece of beefsteak, and some bread. J^aturally a uniform quan- tity should be given at these meals—about 400 grammes [about 13 fl. oz.] of soup, 60 grammes [2 oz.] scraped beef, and 50 grammes [If oz.] wheat bread. This is not so easily carried out, and the same interval should also be allowed to elapse before the examina- tion. With the test breakfast digestion is at its height within one hour after eating, and under normal conditions can be evacuated in a liquid condition ; but in the large meals either no digestion at all, or very little, will have taken place in that time. One must wait at least two to three, and usually four hours, according to the state of the food, or at times upon the condition of the organ, till all the ingredients are digested sufficiently to pass through the tube; and as the fluid portions of the food are absorbed much more rapidly than the sohds, the contents of the stomach after a time become more and more hke mush, so that it may easily happen that at this time a sufficient quantity of the stomach contents can not be ob- * Kleraperer. Ueber die Anwendung der Milch zur Diagnostik der Magen- krankheiten. Charite-Annalen, Bd. xiv. f [The normal amount withdrawn one hour after a test breakfast is between 20 to 60 c. c. [ I |-ij]; quantities much greater than this are pathological.—Ed.]](https://iiif.wellcomecollection.org/image/b21223026_0036.jp2/full/800%2C/0/default.jpg)
