1908.| Hydrochloric Acid in the Gastric Contents in Cancer. 459 
As already said, we did not confine ourselves in the analysis of the test- 
meals to the estimation of those constituents only which we had determined 
in the case of the mice, viz., the total acidity, total chlorides and the 
inorganic chlorides (from which determinations we deduced the. physio- 
logically active hydrochloric acid and the free organic acids), but we also 
determined the free hydrochloric acid by the methyl acetate process, the 
free and organically combined hydrochloric acid by the Morner Sjéqvist 
process, and also the total organic acids, free and combined, all of these 
further determinations having been made by Moore in his analyses of test- 
meals.* We also applied the Giinsburg test in all cases, and where a very 
marked reaction was obtained we also made the test quantitatively. 
We will now briefly discuss the results obtained in these estimations. 
We have shown above that in 13 test-meals which had been withdrawn 
without any addition of water whatever, we obtained an average of | 
01626 per cent. physiologically active hydrochloric acid; five of them 
being above 0:18 per cent. All of these test-meals were obtained from 
cases of undoubted cancer. The standard amount of hydrochloric acid in 
the gastric juice is usually quoted as 0°2 per cent., in healthy individuals, 
and this has been more or less generally accepted, apparently, without any 
very definite basis of authority. Moore states in his paper of March, 1905, 
read before this Society, that in aged individuals the free hydrochloric acid 
is said to be only shghtly over 0-1 per cent., in which case the average 
we find of physiologically active hydrochloric acid (obviously free at some 
time during the process of digestion), is well over normal, inasmuch as 
seven out of the 13 test-meals examined were obtained from individuals © 
between 59 and 64 years of age. As regards our estimations of free hydro- 
chloric acid by the velocity of inversion of methyl acetate, which we carried 
out in the manner referred to by Moore, we obtained an average of 
0:0407 per cent., in the 13 undiluted test-meals from cancer patients, with 
a variation between 0:0022 per cent. and 0°1940 per cent., all the meals 
having been withdrawn exactly one hour after administration. Moore, in his 
first paper already alluded to, quotes 12 cancer cases with an average of 
0:0039 per cent. of free hydrochloric acid, but in his second paper (May 9, 
1906) in the ‘ Bio-chemical Journal,’ vol. 1, p. 274, he quotes 13 additional 
cases with an average of 0°0515 per cent. free hydrochloric acid, or about 
13 times as much as in the previous instances. It certainly seems curious 
that in two series of cases of typical carcinoma there should be this remark- 
able difference, and the fact does not suggest that the determination of free 
* Ten cubic centimetres of filtered gastric contents were invariably taken for these 
estimations. 
° 
