142 Prof. B. Moore. On Free Hydrochloric Acid [Feb. 28, 
not particularly marked. Also, complete suppression of the secretion of the 
acid may occur when only a small patch of the mucous membrane is involved 
by the disease, and where that portion is in the pyloric part in which 
normally no acid is secreted. The usual explanations of the absence of the 
acid in cancer of the stomach, viz., that the absence is due, as in chronic 
gastritis, to local irritation, or to neutralisation of the acid by alkali poured 
in from the ulcerating cancerous surface, seemed to me, therefore, scarcely 
to fit the facts of the case. 
That a small cancerous patch in one region of the stomach, occasionally 
so situated that it leads to no marked dilatation of the organ nor to any 
continued retention of food, should, by some local irritation, cause the. 
suppression of the acid secretion in the remaining apparently healthy 
portions of the mucosa, did not seem to present a very feasible explanation. 
But uf the suppression were not due to local action, to gastritis, or to the 
pathological condition of one portion of the mucosa affecting all the 
remaining portions, what could the explanation be ? 
The idea presented itself that the suppression of the acid might be due 
to a general condition in the body, to alterations of the circulating fluid 
in some way, either by products thrown out by the cancer cells, or as a 
result of changes in the blood which might lead both to the abnormal 
erowth and atypical mitosis of the cancer cells, and to such changes in the 
nutrient medium of the oxyntic cells, that these could no longer separate 
hydrochloric acid from the inorganic constituents of the plasma. 
Such a view, if it could be substantiated experimentally, would naturally 
give a new importance and a different aspect to what is already one of the 
most important experimental facts known about carcinoma. 
The testing of this view was the object set forth in the observations 
recorded below, which have shown that the absence of free hydrochloric acid 
in cancer of the stomach is not due to local action in that organ, for hydro- 
chloric acid is absent or reduced greatly mm amount whatever may be the 
situation in the body of the malignant grorvth. 
It follows that the absence of the acid is due to some change in the 
blood, which change may either be a common cause of the growth and 
the absence of the acid, or may be the result of the growth and the cause 
of the absence of the acid. The significance of this fact will be reverted to 
after the results of the observations have been described. 
It is somewhat remarkable that no systematic observations have hitherto 
been made upon the condition of the gastric juice with regard to hydro- 
chloric acid in malignant disease in other situations than the stomach, or 
