846 HENRY A. MATTILL 



Saline Waters. The first important work on the effects of saline 

 waters on gastric secretion was done by Dapper (b) on persons suffering 

 from gastric disorders; when the usual amount of saline water was given 

 before breakfast he was able to note normal amounts of hydrochloric acid 

 in cases of hypoacidity due to catarrh. Hypoacidity of nervous origin 

 was not affected, while in a number of patients hyperacidity of nervous 

 origin was considerably reduced by the same treatment, thus indicating that 

 the result was not merely a stimulation or inhibition of acid secretion, 

 but a modification of the processes in the epithelium. Later work on 

 patients (Meinel) and experiments on a dog with accessory stomach re- 

 ported by Bickel(a), also showed that saline water given before a test meal 

 caused a slight increase in acidity, a slightly more rapid appearance of 

 the hydrochloric acid and emptying of the stomach. 



Similar experiments on the Homburg Springs (Baumstark) (saline, 

 C0 2 ) showed that these waters brought about a very noticeable increase 

 in the amount of gastric secretion (av. 74 per cent) as compared with ordi- 

 nary water, and also an increase in acid content. The opposite result ap- 

 peared when milk was given with the water, from which it was concluded 

 that the digestion period must not be identical with that in which mineral 

 waters are ingested. The presence of C0 2 may explain the greater stimu- 

 lating effect of the water alone (see below). 



Sasaki, who obtained like results, claimed that the per cent of hydro- 

 chloric acid in gastric juice was riot changed but that the larger amount of 

 secretion was the fundamental thing. Casciani(a) and Coleschi(a) em- 

 phasized the fact that the hypotonic hydrochloric acid waters especially 

 have a stimulating effect, while hypertoiiic waters act as depressants, 

 isotonic having no effect. Whether the tonicity of the gastric contents as 

 such is an important factor has been the subject of considerable experiment 

 and discussion. The existence of a "diluting secretion" was affirmed by 

 Strauss and Eoth such that the higher the molecular concentration of a 

 water, the longer it remains in the stomach and the greater the retardation 

 in the appearance of hydrochloric acid (Strauss, 6). Other investigators 

 (Bonniger; Sommerfeld and Boeder; Otto) have not confirmed the ex- 

 istence of a diluting secretion and the behavior of mineral water in the. 

 stomach bears no simple relation to its molecular concentration (Tauss). 

 However, the delay of gastric function by concentrated waters is, accord- 

 ing to v. Xoorden, a matter of therapeutic importance. Hypotonic solu- 

 tions (Wiesbaden* Kochbrunnen) rapidly become less so in the stomach 



Since these chemical qualities are not likewise "physiological" qualities, it seemed 

 best to retain the older and more familiar classification. As Albu and Xeuberg suggest, 

 balneotherapy may become more useful when the ionic composition of a mineral water 

 is properly considered. While they express great hope for the future of mineral 

 water therapy along the lines of Koeppe's investigation on the osmotic pressure and 

 dissociation constants of mineral waters, no such development seems as yet to have 

 taken place. 



