Under motor function, as a rule, is understood the peristalsis of the stomach and the motion of the in-gesta caused thereby within the organ, as well as the transportation of the food from the stomach into the intestines. I prefer, however, to distinguish that function which serves the purpose of expelling the gastric contents (prochoresis) 1 from the merely mechanical motions to which the ingesta are subjected within the organ (anakinesis).2 This latter function we shall describe later on under the heading of mechanical function.

1. Leube's Method

The oldest method of ascertaining the condition of the motor function of the stomach is that first devised by Leube.3 It consists in washing out the stomach six to seven hours after a large meal (dinner). Normally the stomach is found empty at that time - that is to say, all the food has already left the organ. Where large quantities of food are still found, it shows that the motor function is retarded. Washing out the stomach two to three hours after a smaller meal, like Ewald's test breakfast, may serve the same purpose, for normally the stomach is then found empty.

2. Ewald And Sievers' Method

Ewald and Sie-vers4 have devised another, so to speak, clinical test, for the motor faculty of the stomach. The principle of the test consists in the property of salol, which is a compound of phenol and salicylic acid, of not being decomposed in acid solutions. In relatively feeble alkaline fluids salol is decomposed into salicylic acid and phenol and then absorbed. The gastric contents always being acid, the salol will not undergo any changes there. After leaving the stomach, however, and coming in contact with the intestinal juices which are alkaline, it is quickly split up into its two components. The salicylic acid is then absorbed by the blood and eliminated through the urine as salicyluric acid. The latter is easily recognized in the urine by the violet color produced on the additiou of neutral ferric-chloride solution.

1 the advancing.

2 , the shaking.

3 Leube: "Krankheiten des Magens und Darms." Ziemssen's Handbuch der spec. Path, und Therap," Bd. 17, 2te Halfte.

4Ewald und Sievers: "Zur Pathologie und Therapie der Magen-ectasien." Therap. Monatshefte, August, 1887.

The salol test is made as follows: The patient takes 1 gm. salol in two gelatinous capsules half an hour after a slight meal. Before the ingestion of the capsules he empties his bladder, and then urinates every half-hour for about two hours. All the different specimens of urine are then examined with ferric chloride solution, and it must be ascertained in which specimen the violet color begins to appear. Normally it requires about an hour until the appearance of salicyluric acid in the urine; while in case of retarded motion of the stomach it takes two hours and even longer. In order to detect the earliest trace of salicyluric acid, Ewald first advised treating the urine with ether and then making the test in the ethereal residue. Afterward Ewald and I1 suggested a simpler method which permitted us to dispense with the ether. This consists in moistening a piece of filter paper with the urine, and then placing a drop of ferric chloride solution by means of a glass rod upon the middle of the moistened paper. The edges of the drop will assume a violet color in the presence of even the smallest trace of salicyluric acid.

These papers may be dried and preserved and in this way one can easily compare the reactions of the urine in the same patient at various times.