REHFUSS— THE NORMAL GASTRIC SECRETION. 467 



every stimulus with an abundant secretion, " hyperacidity " whose 

 response although possibly not excessive is still of a high acid grade. 

 However it is found that those individuals with excessive quantity 

 compared to a normal mean usually show also hyperacid compared 

 to a normal mean which one might call the " isoacid " figure. 



In other words after studying the average collective response of 

 all normal individuals it becomes apparent that while the motor func- 

 tion in perfect health varies within very narrow limits, the quantity 

 and quality of the secretion has considerable variations. There is a 

 group by no means small in which the secretion is very abundant, 

 the acid figure high, and there is often present a post-digestive or 

 continued secretion. These people always react in this way while 

 there is a group diametrically opposed who show a rather tardive 

 secretory response. Both are normal : both without symptoms : both 

 must be considered in the analysis of any pathological case. 



Careful study as far as I can ascertain seems to demonstrate that 

 hypersecretory individuals give hypersecretory responses to all forms 

 of gastric stimuli. Whether it be bread, bread and tea, meat, milk or 

 a mixed meal — our " hypersecretory " students give always an hyper- 

 secretory response — and our hypersecretory normal type give as a 

 rule with any form of stimulus a low or a so-called hyposecretory 

 response. In the many experiments numbering several thousand we 

 have been able to predict almost always the type of response which 

 a certain individual would give after trying him out with a certain 

 substance. Of course there are daily variations and extreme fatigue 

 as well as gastric abuse will entirely change the gastric output as we 

 have been able to demonstrate. 



These findings are extremely important because they must make 

 us cautious in drawing unwarranted diagnostic conclusions on the 

 cjuantity and quaHty of the secretion. In over 4-0 per cent, of our 

 cases, we found figures exceeding 60 total acidity and it is perfectly 

 apparent that the diagnosis of pathological hyperacidity for figures 

 exceeding 60 must be entirely rewritten when it is evident that this 

 occurs at some phase in the digestive cycle of many normal in- 

 dividuals. 



Over 30 per cent, of normal cases develop an acidity in excess of 

 70 or 0.25 per cent. HCL and the probabilities from our experi- 



