Condition Of The Gastric Juice

In most cases one encounters a decrease in the HC1 secretion and in the acidity of the stomach contents. In some there is always found a considerable amount of mucus. Occasionally, however, there is found superacidity caused by an increased HC1 secretion.

Course

The course of this pathological condition is a very prolonged one. Several of the patients appear to suffer from it for many years. Although there may be intervals of perfect euphoria (at the same time probably the inner layer of the stomach is completely intact) for a longer or shorter period of time, the old symptoms do, however, sooner or later return.

One would imagine that cases of erosions of the stomach would present a very fruitful soil for the development of ulcers. This, however, does not seem to be the case, for in none of the patients was there any justifiable supposition of an existing ulcer during the long course of the sickness.

As typical cases of this affection we mention the two following cases:

Case I. February 11th, 1893

H. S------, aged 35, merchant, suffers for two to three years from digestive troubles. These consist principally in the appearance of pains right after meals; the pains are not severe; they produce, however, the effect that patient eats less. There is a feeling of fulness; bowels constipated. Patient always feels weak and tired.

The examination reveals: chest organs intact; the gastric region is sensitive to pressure; there is splashing sound extending two fingers' width below the navel; right kidney movable.

The examination of the stomach contents one hour after Ewald's test breakfast showed: HC1 +; acidity = 60.

February 13th

When fasting, stomach empty. Lavage: in the wash-water three small red pieces of mucous membrane are found. Spray with silver nitrate.

February 14th

Intragastric galvanization.

February 15th

Lavage: in the wash-water three small red pieces of mucous membrane appear. A fresh microscopic specimen shows gastric glands. Spray with silver nitrate.

February 16th

Patient feels better - i.e., he is stronger, can eat more, and is not troubled with pains. Direct galvanization of the stomach.

February 17th

Lavage: no pieces of mucous membrane are found. Spray with silver nitrate.

February 18th

Intragastric galvanization.

February 19th

Lavage: no pieces of mucous membrane. Spray with silver nitrate.

February 20th

Intragastric galvanization.

February 21st

Examination of the stomach contents one hour after the test breakfast: HC1 +; acidity = 54; no pieces of mucous membrane.

February 22d

Direct galvanization of the stomach.

February 23d

Lavage: no pieces of mucous membrane. Spray with silver nitrate.

February 24th

Intragastric galvanization. Patient had to return to his native city, Chicago, on account of urgent business. As I have recently heard, patient felt well all the time with but few intervals.