


1905.| in Gastric Contents in Malignant Disease of Organs. 145 
glass rod to a porcelain capsule, a drop of the reagent added from a dropping 
bottle, and the mixture evaporated to dryness, preferably on a steam or water bath. 
If even a trace of free hydrochloric acid is present, the characteristic red colour 
appears. In that case, a quantity of deci-normal alkali is added to the 10 cc. 
of filtered contents, from one- or two-tenths of a cubic centimetre to 1 c.«,, 
according to the depth of colour obtained on the initial testing. The process of 
testing is then repeated, if a positive result is obtained more alkali is added, the 
testing repeated, and so on, until a negative result is obtained. Near the end, 
when the reaction is less marked, the alkali is added in quantities of 0°1 c.c. at a 
time. A little practice enables one to carry out the testing in about five minutes 
in all, and reduces the number of operations to four or five. As only about 0:1 c¢.c. 
is removed for each test, and the acid is almost neutralised when the final drops 
are removed, the loss in this way is very small. 
In many of the cases of malignant disease it will be observed that the test was 
negative from the outset, showing entire absence of free hydrochloric acid. 
(d) Modified Morner-Sjoqvist Determinations*® of Free and Combined Hydrochloric 
Acid.—We have used this method as a gravimetric one in the modification described 
by v. Jaksch.t The method consists in converting all the acids present into barium 
salts by the addition of barium carbonate (previously tested, and found free from 
soluble barium salts). Ten c.c. of the gastric contents are taken,{ and about half-a- 
gramme of the fine dry barium carbonate powder added. The mixture is well 
shaken up and allowed to stand for about an hour, it is then evaporated down to 
dryness in a platinum or nickel crucible, and incinerated. In the process of 
incineration, the barium salts of the organic acids, if any are present, are 
destroyed, and barium carbonate is re-formed, while the barium chloride formed 
from the hydrochloric acid (free or combined with proteid) present in the gastric 
contents is unchanged in the process of incineration. After incineration, the 
incinerated mass is extracted several times with hot water, and the washings 
filtered free from barium carbonate. 
The clear solution from the united washings measures approximately 50 c.c., 
when the washing is complete, and contains an amount of barium chloride which 
represents the total amount of free and combined hydrochloric acid in the original 
10 c.c. of gastric contents. 
The end of the process consists in determining the amount of barium chloride in 
the solution. Different volumetric methods have been proposed for this deter- 
mination, but we have considered it more accurate to follow v. Jaksch’s 
recommendation of weighing the precipitate. 
The barium is precipitated in the usual way, at the boiling point, as sulphate by 
addition of a few drops of dilute sulphuric acid, kept at near 100° C. for about an 
* ‘Zeitsch. f. physiol. Chem.,’ vol. 13, 1889, p. 1. 
t+ ‘Monatsheft. f. Chemie,’ vol. 10, 1889, p. 211; ‘Klinische Diagnostik innerer 
Krankheiten,’ 3te Auflage, 1892, p. 155. 
{ Where previous titration in the malignant cases had shown that the total amount of 
acid was low, 20 to 50 cc. were taken where available, so as to give a better chance of 
obtaining a figure for any minimal trace of hydrochloric acid which might be present. 
