1. Ewald Und Einhorn

"Verhandlung. des Vereins f. innere Medicin," 1888, p. 58. Max Einhorn: "Die neueren Methoden der MagenuntersuchuDg." New Yorker mediz. Monatschr., Marz, 1889.

Ruber's Modification

Although normally, as a rule, the salicyluric acid appears in the urine about one hour after the ingestion of the salol, there are exceptions in which even in healthy people the reaction is greatly retarded. For this reason Huber1 suggested to determine the length of time required for the complete disappearance of the reaction in the urine; for it is readily understood that the longer the time required for the salol to be absorbed and entirely eliminated through the urine the longer it has remained within the stomach. When the urine gives no reaction whatever, it shows that the whole amount of salol has long since left the stomach, and has been eliminated from the organism. In case of retarded motion of the stomach, parts of the salol remain and leave this organ only after a very long time. In this way the reaction of the salicyluric acid will extend over a prolonged period. Huber found that normally the excretion of the salicyluric acid after 1 gm. of salol lasted twenty-four hours; in patients with enfeeblement of the motor function of the stomach it lasted forty-eight hours or even longer.

1 Huber: "Die Methoden zur Bestimmung der motorischen Thatig-keit des Magens." Correspondenzbl. f. Scliweiz. Aerzte, 1890.

The salol test, as suggested by Ewald or as modified by Huber, certainly gives a clew as to the condition of the motor function of the organ and is clinically of value, although either of them is by no means absolutely reliable.

S. Heichelheim1 made use for the same purpose of iodipin, which is not decomposed in the stomach. He administers 1.6 gm. of iodipin in gelatin capsules at breakfast. The saliva is then examined every fifteen minutes for the presence of iodine (by means of starch paper and fuming nitric acid). In most instances the reaction appears before the end of an hour. In pyloric obstruction it is greatly retarded.

3. Klemperer's Oil Test

Oil is not absorbed by the stomach wall. If, therefore, a certain quantity of oil be ingested and the stomach emptied after a certain period, it will be possible to judge from the amount of oil withdrawn the state of the motor faculty; for the greater the quantity of oil recovered the less has left the organ. Kleinperer2 proceeds as follows: After washing out the stomach, he pours about 100 c.c. of pure olive oil into the empty organ. Two hours later the stomach is aspirated and whatever oil is left removed as thoroughly as possible. The difference between the original quantity of oil and that withdrawn indicates the state of the motor function of the stomach. According to Klemperer, normally at this time only 20 to 40 c.c. of the oil ought to be found. This method, however, is complicated and to some objectionable; and as the results obtained by it do not allow more conclusions than the method of Leube, it has not come into extensive practical use.

1 S. Heichelheim: Zeitschr. fur klin. Med., 1900, p. 831. 2 Klemperer: "Ueber die motorisclic Thatigkeit des menschlichcn Magens." Deutsche med. Woeheusehr., 1888, No. 47.

4. Examination Of The Stomach In The Fasting Condition

The best and easiest way to test the motor function of the stomach is to examine this organ, by means of the tube and lavage, in the morning in the fasting condition after the ingestion of a substantial supper on the night previous. Normally the stomach is empty, and therefore when the organ is found to contain a quantity of food, this is the best sign of retarded motion. This method is practically used by most writers.