ig8 COMPOSITION OF THE DIGESTIVE JUICES. [CH. VIII. 



Total acidity .. .. 0-14 to 0-26 



Total chlorides . . 0-2 to 0-3 



Mineral chlorides .. 0-09 to 0-12 



Active HC1 .. .. 0-14 to 0-26 



Free HC1 .. .. 0-07 to 0-15 



G. Graham [Quarterly Journal of Medicine, IV., p. 315 

 (1911) ], has published an interesting series of cases. The 

 average results he obtained are as follows : 



Total Mineral Active Ratio 



Chlorides. Chlorides. HC1. Active: Mineral. 



Gastric ulcer . . 0-335 *99 0-236 238 : 100 



Dilated stomach .. 0-256 0-094 0-182 194: ooo 

 Carcinoma of 



stomach.. 0-197 0-142 0-052 37: 100 



It will be noted that in carcinoma of the stomach the 

 ratio of active HC1 to mineral chlorides is markedly sub- 

 normal, due to a decreased secretion of HC1 and the 

 neutralisation of a good deal of this by some alkaline 

 secretion. This change would seem to be more diagnostic 

 than the absence of free HC1, since the latter occurs in 

 certain other pathological conditions. In gastric and 

 duodenal ulcer there is an increase in the amount of free 

 and active HC1, and the active mineral ratio is apt to be 

 above normal. 



Mixture for analysis. The following mixture can be analysed for the 

 purpose of acquiring the necessary technique : 



1 per cent, sodium chloride . . . . 14 cc. 

 o-i N. HC1 50 cc. 



2 per cent, peptone . . . . . . 26 cc. 



Distilled water to make . . . . 100 cc. 



243. Total acidity. To 10 cc. add 4 drops of a 0-5 per cent, 

 solution of phenol phthalein in 50 per cent, alcohol. Titrate with 

 o-i N. soda until a faint but definite pink tinge is obtained. The 

 end point is not very sharp, owing to the buffer action of the peptone. 



Calculation. I cc. of o-i N. NaOH = 0-00365 gram. HC1. 

 Express the result in grams, of HC1 per 100 cc. 



