Am.  Jour.  Pharm. 
January,  1898. 
'•}     Analysis  of  the  Gastric  Contents. 
tive  function  as  the  Leube.  A  patient  might  have  sufficient  diges- 
tive capacity  to  completely  digest  an  Ewald  meal,  and  yet  not  suffi- 
cient to  digest  the  ordinary  mixed  meal  taken  by  a  person  of  health 
and  vigor.  If  this  is  the  case,  the  deficiency  will  appear  in  the 
quantitative  results  obtained  after  the  Ewald  meal.  And  where 
such  a  condition  is  suspected  or  indicated,  a  Leube  meal  can  be 
given  after  the  Ewald  test  has  been  applied. 
The  Ewald  test  breakfast  is  given  on  a  fasting  stomach.  Thus 
the  meal  may  be  given  at  8  a.m.,  the  patient  having  fasted  since  the 
dinner  of  the  night  before. 
One  hour  after  ingestion  of  the  meal,  the  stomach  tube  is  passed 
and  the  contents  expressed. 
The  choice  of  one  hour  as  the  period  of  elapsed  digestion  before 
expression  is  founded  upon  experimental  research.  The  most  com- 
plete information  can  be  secured  if  the  contents  be  obtained  at  the 
period  when  all  the  physiological  agents  of  digestion  are  present 
and  active,  and  when  the  quantity  of  these  approaches  the  maxi- 
mum. This  period  has  been  found  to  be  practically  one  hour  after 
the  ingestion  of  the  Ewald  meal. 
As  it  is  impossible,  in  ordinary  clinical  work,  to  obtain  the  con- 
tents in  each  case  at  exactly  one  hour  after  ingestion,  I  have  this 
year  made  an  investigation  for  the  purpose  of  determining  the  effect 
of  a  longer  interval  than  one  hour  upon  the  results  in  regard  to  the 
important  conditions  investigated. 
The  investigation  consisted  of  the  examination  of  the  contents 
expressed  one  hour  after  an  Ewald  meal  in  fifteen  normal  cases,  and 
an  examination  of  the  contents  expressed  one  and  one-half  hours 
after  this  meal  in  fifteen  cases.  The  results  may  be  seen  in  the  fol- 
lowing table  of  averages : 
TABLE  I. 
Average  quantity  of  mixed  contents  .  .  .  120  c.c. 
Average  total  acidity   2gm.p.m. 
Starch  present   2  cases. 
Erethrodextrin  present   8  " 
Albumin  present   15  " 
Free  HC1  present   15  " 
Lactic  acid  present    o  " 
1  Hour. 
1%  Hours. 
IOO  C.C. 
2*oi  gm.  p.m. 
2  cases. 
6 
o 
<  1 
The  conclusion  to  be  drawn  from  these  results  is,  that  the  condi- 
tions, the  estimation  of  which  is  of  importance  in  clinical  work,  do 
