80 CLINICAL MICROSCOPY AND DIAGNOSIS. 



SECTION III. 

 Gastric Contents. 



Examinations of the gastric contents are required to 

 obtain information of the condition and digestive power 

 of the normal gastric juices, and to determine the 

 presence of any abnormal constituents, such, for in- 

 stance, as the products of fermentation. Accurate in- 

 formation, upon which conclusions can be based, is 

 only to be obtained after several examinations and the 

 use of test meals on a food free stomach, the contents 

 being withdrawn at a set period. 



The most commonly employed test meal is the test 

 breakfast of Ewald and consists of 35 to 40 grammes 

 white bread, and 300 cc. of water, or tea without milk 

 or sugar. This is withdrawn one hour afterward, if 

 possible, without the use of water. If water has to be 

 used, measured small quantities only should be em- 

 ployed. At the expiration of one hour, normally about 

 40 cc. of contents can be withdrawn, and in this we 

 can demonstrate the presence of free and combined hy- 

 drochloric acid, pepsin, rennet, peptone and glucose. 



Boas advises a special test meal in cases of suspected 

 carcinoma of stomach. It consists of from 350 to 400 

 cc. of oatmeal gruel made with water and salt, and given 

 at night, after lavage of the mouth and stomach. Eight 

 or ten hours afterwards the contents are expressed. 

 The meal is given to prevent the introduction of lactic 

 acid in the food, and the tests are made for lactic acid 

 alone. 



