REHFUSS— THE NORMAL GASTRIC SECRETION. 4G9 



whole subject of pathological gastric chemistry. In only two in- 

 stances out of 12 atropine experiments did the total acidity exceed 

 70 (16.6 per cent.) and they were 79.5 and 71.5 respectively, while 

 in four of those cases (33 per cent.) the free acid exceeded 50. In 

 other words, it was possible to demonstrate directly a definite reduc- 

 tion both in the quantity and in the acidity of the psychic secretion 

 after the administration of atropine. 



(/) On a pathological case (ulcer) we were able to demonstrate 

 a marked increase in the quantity of the psychic secretion under the 

 same circumstances as well as an increased velocity in the formation 

 of the secretion. 



While the psychic response may vary markedly under certain 

 circumstances, the phase which we call chemical late in digestion 

 and which we attribute to secretagogues, hormones, the formation 

 and absorption of certain gastrins, is remarkably constant. 



Normally the factor of safety is very great in the stomach, 

 but any pronounced deviation from normal whether due to excessive 

 ingestion of indigestible food, indulgence in alcoholic liquors or to 

 marked fatigue of any kind is usually followed by recognizable 

 gastric disturbances, among which are a tendency to excess of or 

 persistent secretion and frequently minimal food retention due to 

 disturbed motility. 



A consideration of the foregoing facts enables us to construct a 

 rational basis for the interpretation of pathological phenomena. In 

 the first place it must be evident that normally the evacuation time 

 is remarkably constant. Abnormally any variation can occur from 

 a marked acceleration of the gastric contents seen in certain forms of 

 achylia and in the accelerated peristalsis of certain forms of duodenal 

 ulcer and duodenal irritation to the delayed evacuation only partial 

 seen in certain forms of atony to the pronounced delays seen in the 

 various forms of pyloric stenosis. 



From a secretory standpoint, many things may occur. The 

 evolution may be entirely abnormal. The development of the secre- 

 tion may be accelerated or retarded, in reality delayed gastric 

 digestion ; or there may be at any phase in the gastric cycle the 

 entrance of pronounced secretory perturbations as hypersecretion or 

 the elimination or secretion of a juice of high acid grade. The 



