138 CONTENTS OF THE INTESTINAL CANAL. 



alcoholic extracts assumed a dark blood-red tint with the per-salts 

 of iron. Similar kinds of alkaline vomited fluids have been 

 examined by Wright, Nasse,* and Bird.f 



We very often observe a fluid, watery, vomited matter 

 with a strong acid reaction ; it occurs in the round (perfo- 

 rating) gastric ulcers and probably also in nervous spasm ot the 

 stomach (if such a thing actually exist). Unfortunately these 

 fluids have been examined with so little care, that even if lactic, 

 butyric, or acetic acid has been actually recognized in them with 

 chemical certainty, it has not been decided whether the excess of 

 acid is produced in the same way as in softening of the stomach in 

 children (Elsasser) by the rapid fermentation of portions of amy- 

 laceous or sugar-forming food retained in the stomach, or whether 

 it has accumulated in the stomach in consequence of an abnormal 

 secretion from the gastric glands. 



The fluids of this class that have been most frequently analysed 

 are the rice-water matters vomited in cholera ; both in their phy- 

 sical and in their chemical properties they are almost perfectly 

 identical with the matters often vomited in uraemia; they are 

 usually of a faint, sickly odour, and their reaction may be either 

 acid, neutral, or alkaline ; on standing, they deposit greyish 

 white flakes, consisting of epithelial structures or intestinal 

 mucus, while the fluid above appears clear and yellowish. With 

 the exception of very beautiful groups of cylindrical epithelium, 

 we find in these fluids only few organic matters ; but, on the other 

 hand, they contain a relatively large amount of inorganic salts, and 

 especially of chloride of sodium, with a small quantity of alkaline 

 sulphates. It entirely depends upon the stage of the disease 

 whether the fluid is acid or alkaline ; for a short time after the 

 beginning of the disease the vomited matter is acid, and I found 

 in it (as HermannJ had done) butyric and acetic acids, (and metace- 

 tonic acid was also very probably present.) When the fluid con- 

 tained no remains of food, but resembled rice-water, and was acid 

 or neutral, I constantly found urea, and can thus confirm the ob- 

 servations of Schmidt. If, on the other hand, the disease was 

 further advanced, and the cerebral symptoms accompanying 

 uraemia had set in, and if vomiting now came on, salts of am- 

 monia, and especially the carbonate were found, and hence the fluid 

 had an alkaline reaction. Albumen occurs only in very small 



* Med. Corresponzbl. rh. u. westph. Aerzte, 1844. No. 14. 



t Lond. Med. Gaz. Vol. 29, p. 378, andVol. 30, p. 931 . 



Fogg. Ann. Bd. 22, S. 169. Charakteristik der Cholera, u. s. w. S. 72. 



