GASTRIC ANALYSIS 151 



gastric digestion and is not limited, as in the old method, to information 

 derived from the analysis of a single sample of stomach contents with- 

 drawn at the end of one hour. That the acid values obtained by the 

 old method may be grossly misinterpreted and lead to an incorrect 

 diagnosis is indicated by the foregoing diagram (Fig. 45) . 



It is set forth in the above diagram that various types of abnormal 

 gastric secretion would be considered normal on the basis of a single 

 examination at the end of one hour whereas the application of the 

 fractional method reveals the abnormality of the secretion and enables 

 a rapid and correct diagnosis. The removal of samples of gastric 

 contents at short intervals, for a period of two hours or more afte^ a 

 test meal, is made possible by the use of a modified stomach tube 1 of 

 small diameter (No. 12 French tubing) and fitted with a metal tip. 



FIG. 46. REHFUSS STOMACH TUBE. 



The tip is slotted with large perforations, the diameter of each^being 

 equivalent to the maximum bore of the tubing. Such a tube can be 

 left in the stomach through the entire cycle of gastric digestion without 

 inconvenience to the patient. 2 A cut of the Rehfuss stomach tube 

 (Fig. 46) is shown above. 3 Lyon has suggested a modified tip. 4 



More recently Bergeim, 5 working in the author's laboratory, 

 has devised a very useful apparatus for the determination of in- 

 tragastric conductance and temperature. The apparatus is also provided 

 with an aspiration tube similar to that of the Rehfuss tube which 

 make possible the removal of samples of gastric contents for chemical 

 analysis. This apparatus is shown in Fig. 47, page 152. Curves 



1 Rehfuss: Am. Jour. Med. Sci. t June, 1914. 



2 McClendon has recently suggested the introduction of an electrode into the stomach in 

 an attempt to follow the consecutive changes in the hydrogen ion concentration of the 

 stomach contents (see Am. Jour. PhysioL, 38, 180, 1915). 



8 This tube is manufactured by Charles Lentz & Sons, Philadelphia. 

 4 Lyon: /. Am. Med. Ass'n., 74, 246, 1920. 

 5 Bergeim: Amer. Jour. PhysioL, 45, i, 1917 



