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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![Tests for Total Acidity.—This is ascertained by adding to the stomach contents a sufficient quantity of an alkahne solution of definite composition which will neutralize all the acid contained in them. The question a'c once arises whether we should em-ploy filtered stomach coutents, as has been done heretofore, or whether we should follow the sug- gestion of Martins and Lllttke to use them unfiltered. It is self-evideut that different results will be obtained according as we make use of the one oi the other. But the above-mentioned writers have neglected one very imxjortant fact, that in either case absolute values are never obtained, but only relative ones. Absolute values are never obtained, because in deter- mining the acidity by titration very different results are found with the various indicators employed ; and we must never forget that in all these procedures we are dealing with certain signs whose natru'e and useful- ness consist in the fact that they may be compared with one another. In measuring unfiltered stomach contents the results will vary with the quantity of larger or smaller fragments of food contained in them, and the titrimetric error will be much greater because the unfiltered stom- ach contents must be strongly diluted in order that they may be used for titration. Experiments with such a complex mixture as the stomach con- tents differ rachcally from those with pm-e solutions. The fact that we estimate all results by percentage instead of by absolute values has this advantage, that it suffices to determine the proportional values. It is self- evident that in the unliquefied fragments of food a certain amount of HCl has been imbibed, the absolute amount of which may be determined if we use unfiltered stomach contents. But inasmuch as the course of digestion is such that a corresponding amount of HCl is also in solution (free, or combined with the dissolved albumin), then the estimation of the latter will also give us indications of the amount of the former; in other words, the amount of work accomplished by the stomach. And that is the very thing which we wish to ascertain. But since it is much easier and more convenient to use filtered stomach contents, and since filtration at the same time also offers certain other diagnostic data, I believe that I am justified in adhering to the old method of studying the chemical changes with filtered chyme. The same is true of the suggestion of Geigel and Blass *—to discuss this point at the same time—that we should estimate the total quantity of acid which is present in the stomach at that particular period in order that we may use this as a means of estimating the functional activity of the organ. Concerning this I would say the following : The advantage of percentage estimations is this, that they give us re- sults which are independent of the total quantity and which may be used Friedenwald. IST. Y. Medical Journal, March 23, 1895; and Stewart. Medical News, February 16, 1895.—Ed.] * G.eigel und Blass. Procentuale und absolute Aciditiit des Magensaftes. Zeit- sehr. fiir klin. Med., Bd. xx, Heft 3. Geigel und Abend. Die Salzsaureseeretion bei Dyspepsia nervosa. Virchow's Archiv, Bd. cxxx, Heft 1.](https://iiif.wellcomecollection.org/image/b21223026_0045.jp2/full/800%2C/0/default.jpg)
