CHAPTER XXIX. 

 THE STOMACH CONTENTS. 



FROM a microscopical stand-point there is comparatively little that 

 is of value in the examination of the gastric contents ; there is nothing 

 very specific about the findings. 



A test meal is not a necessity as in the chemical examination, but 

 either vomitus or material withdrawn with a stomach-tube two or more 

 hours after an ordinary meal suffice. 



The microscopical diagnostic points in connections with distin- 

 guishing cancer of the stomach from nonmalignant dilatation are: (i) 

 Fragments of cancer tissue. These are very rarely found and are 

 most difficult to diagnose. (2) The presence of flagellates in the early 

 stages of cancer (the so-called anacid stage preceding the development 

 of lactic acid). As flagellates prefer an alkaline medium, they disap- 

 pear after the acidity due to lactic acid comes on. (3) The presence of the 

 Boas-Oppler bacillus. There are probably several organisms so 

 designated. They are lactic acid producers and are characterized by 

 being very large bacilli (7x1/1) and arranged in long chains which 

 stretch across the field of the microscope. They are Gram positive 

 and do not form spores. They can be cultivated on media rich in 

 blood and are aerobic. They should only be reported when present 

 in great abundance and in long chains. (4) The absence of sarcinae 

 and yeasts. The presence of these cocci and fungi in vomitus is 

 indicative of a simple dilatation. 



270 



