1908.) Hydrochloric Acid in the Gastric Contents in Cancer. 461 
raised by Moore that the method is liable to estimate other inorganic acids 
than hydrochloric, which he suggests might be present. He makes, however, 
no statement as to the particular morganic acids intended, Inasmuch as 
phosphate and sulphate of barium are insoluble salts, there only remains 
nitric acid, the barium salt of which is decomposed on ignition. In our 
opinion, this Morner Sjoqvist method is. fairly accurate, but that it is not 
applicable in certain cases is shown above, and as there are other objections 
to it, not the least of which is the length of time it requires, we do not. see 
any advantage in its employment, since Volhard’s method amply suffices. 
Neither Palmer, nor Moore, in his second paper, make any allusion to the work 
of Liittke or Willcox, in which Volhard’s method was employed. 
With reference to the estimation of the organic acids, free and combined, 
we have made estimations in all cases by the method used by Moore, and the 
average result in 12 undiluted test-meals was 0°0331 per cent., with a 
variation from 0:0036 to 0:1022 per cent. Here, again, we differ from Moore, 
whose results are invariably low. We obtained, from our own determinations 
referred to above, the figures for free organic acids. by difference, but in all 
but four cases they were entirely absent. 
So much has been written of late with reference to the Giinsburg reaction 
that it is unnecessary to enter into any detail here. It will therefore suffice 
to say, as regards our own experience, that in only a very few cases in all the 
test-meals examined, even those which had been diluted, did we fail to get a 
more or less marked reaction, and in the five cases in which the test was 
made quantitatively, three of the results approximated to the figure obtained 
by the methyl acetate process, while two were distinctly higher. 
Conclusions—It would appear, therefore, from our experiments on test- 
meals from cancer patients, that the physiologically active hydrochloric acid, 
although appearing in a few cases to be somewhat low, can, in the majority of 
instances, be regarded as normal, or even above normal, according to the 
standard of hydrochloric acid accepted as normal. It may be that possibly the 
free hydrochloric acid in the gastric contents is liable to be diminished in 
disease, whether malignant or not; but unless the experiments are made 
under rigid precautions as to avoidance of dilution in withdrawal of the 
test-meals, and unless the observations made by different observers have 
reference to exactly the same period of digestion, any comparison of results 
and any deductions from them must tend to be fallacious. Moreover, as 
already shown, free hydrochloric acid in the gastric contents may at any 
moment become combined with proteids and nitrogenous organic bases, and it 
is obvious that the rate of secretion of hydrochloric acid in the gastric juice, 
inasmuch as it varies in healthy individuals, may also be expected to vary 
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