The diseases of the stomach / by Dr. C.A. Ewald.

  • Carl Anton Ewald
Date:
1900
Catalogue details

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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    tents in gastrectases due to benign and cancerous pyloric stenosis.* Ptomaines seem to play an important part in the causation of tetany (see Chapter YI). Strauss f has recently reported a case in which both sulphureted hydrogen and indol were found; he was able to cultivate the bacil- lus coh communis from the stomach contents. In cultures this bacillus produced HaS.] The duantitative Determination of Acidity.—The quantitative de- termination of the amount of HCl secreted must determine two things: (1) The amount of free HCl; (2) the amount of HCl which, as explained above (page 25), has combined* with bases and organic substances. The sum of (1) and (2) will give the total amount of HCl secreted. This value, however, can only be de- termined if we introduce food into the stomach which is totally free from chlorides, or if the amount of chlorides which has been introduced is exactly known. Both of these procedures would be very difficult, and would scarcely be feasible for ordinary practical work; and, furthermore, for the following reasons they are un- necessary. It is true that with the test dinner, and especially with the test breakfast, we introduce a certain quantity of chlorides and bases, the latter of which are converted into chlorides by the HCl which is secreted; yet we have at present no simple method with which we can distinguish the chlorine of the chlorides which are introduced into the stomach and those which are formed there. On the contrary, in the ordinary methods of analysis the chlorine of the total chlorides is ascertained and is calculated as HCl. But the chlorides which have been introduced do not interest us. The chlorine which they contain has nothing to do with the work of the stomach, and is a variable factor which differs in the various cases, which, for example, varies if the bread or the dinner which is eaten contains more salt than usual. At all events, the bases and weaker salts are converted into chlorides by the secreted HCl, and thus take up a certain quantity of the secreted HCl; yet this is only a very small fraction of the total amount of HCl. !N^ow, as the * [Kulneff. Berl. klin. Wochenschr., 1893, No. 17. Turck. Toxines of the Stomach, N. Y. Medical Journal, February 32, 1896.—Ed.] ■<• [Strauss, Berl. klin. Wochenschr., May 4, 1896.—Ed.]
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