On the Absence or Marked Dimainution of Free Hydrochloric Acid 
im the Gastric Contents, in Malignant Disease of Organs other 
than the Stomach. 
By BenJAMIN Moor, M.A., D.Sc., Johnston Professor of Bio-Chemistry in the 
University of Liverpool (in collaboration with W. ALEXANDER, M.D., 
M.Ch., F.R.C.8., Hon. Surgeon, Royal Southern Hospital, Liverpool ; 
R. E. KELty, M.B., B.Ch., B.Sc., Alexander Fellow, University of Liver- 
pool; and H. E. Roar, M.B., Johnston Colonial Fellow, University of 
Liverpool). 
(Communicated by Professor C. 8. Sherrington, F.R.S. Received February 28,— 
Read March 16, 1905.) 
It is well known that free hydrochloric acid is absent in a large proportion 
of cases of cancer of the stomach. 
This was first noticed by Reinhard von den Velden* in 1879, and evoked 
a great deal of attention and experimental work, as a result of which some 
observers confirmed, while others disputed von den Velden’s statement. But 
in the end the result that free hydrochloric is absent in the majority of cases 
of cancer of the stomach has become firmly established as one of the few 
experimental facts amid a mass of theory that we know regarding cancer. 
It would be out of place in a preliminary paper such as the present to 
attempt a complete history of the enormous literature on the presence or 
absence of free hydrochloric acid in the stomach contents in cancer of that 
organ, so only a few of the prominent results recorded will be noticed as an 
introduction to the observations which form the subject of this communication. 
In his original paper, von den Velden used methyl]-violet as an indicator for 
free hydrochloric acid, and examined cases of dilatation of the stomach, due 
on the one hand to stenosis of the pyloric opening caused by carcinomatous 
erowth, and on the other to various other causes. He found in ten cases of 
dilatation which were not due to carcinoma that free hydrochloric acid was 
always present, while in eight cases of cancer of the pylorus, free hydrochloric 
acid was uniformly absent, and he suggested such testing as a diagnostic sign 
for cancer of the stomach. 
C. A. Ewaldf raised objections to methyl-violet as not being a sufficiently 
sensitive indicator for free hydrochloric acid, and stated that in 25 cases of 
* ‘Deutsches Archiv f. klin. Medicin,’ vol. 23, 1879, p. 31. 
t ‘ Zeitsch. f. klin. Medicin,’ vol. 1, 1880, p. 619. 
