APPENDIX 



469 



determination in place of the more expensive colorimeters such as those of Duboscq 

 and Hellige. A cut of the apparatus is given. As a rule, I make up my known 

 standards with urine instead of water as giving better comparison and pour a darker 

 known solution from a graduated cylinder into a Nessler jar as described under 

 blood-sugar estimations. 



FIG. 115. Dunning colorimeter. 



F CHEMICAL EXAMINATION OF GASTRIC CONTENTS 



The test breakfast ordinarily used is that of Ewald (one shredded wheat biscuit 

 or two small pieces of toast with 400 c.c. of water is what is usually given). This 

 Ewald breakfast is a low-grade stimulant to acid production. It is given in the 

 morning on an empty stomach. If at supper, the night before, the patient partake 

 of raspberry jam the finding of the characteristic seeds in the stomach contents 

 the next morning would be evidence of lack of motor activity. The Fischer meal 

 which contains a 4-ounce Hamburg steak in addition to the water and toast of the 

 Ewald is withdrawn after three hours. v 



The stomach tube is more easily passed if it be thoroughly chilled in ice water 

 without the use of any lubricant. 



The stomach tube should be passed one hour after the Ewald breakfast and if 

 more than 50 c.c. of fluid be obtained it indicates stasis or hypersecretion. 



Free HCL Filter the gastric contents and test first for free HC1. The most 

 reliable and sensitive test is that of Gunsberg. The reagent, which should be 

 freshly prepared, consists of phloroglucin 3 grams, vanillin i gram, and absolute 

 alcohol 30 c.c. By mixing 2 drops of gastric juice and an equal quantity of Gunsberg 

 reagent in a small porcelain dish and carefully heating above a flame we obtain a 

 carmine red color if free HC1 be present. A water-bath is preferable. 



The Gluzinski test is of value in the diagnosis of gastric cancer. In this, three 



