The Chloride, Base and Nitrogen Content of Gastric Juice After Histamine Stimulation

In previous papers (1) the inadequacy of the usual test meal methods of studying gastric function has been discussed. It was pointed out especially that acid titration values obtained from specimens aspirated from the stomach after a test meal varied with an unknown factor-namely, the speed of gastric emptying, and that in certain cases apparent absence of hydrochloric acid was due simply to neutraliza-tion by stomach contents. A procedure which obviated many of the variables of the older tests was introduced (2), but in order to obtain a still more accurate insight into the mechanism of gastric secretion further analysis of the constituents of the stomach juice seemed necessary. The object of the present work was to estimate, after a standard stimulus, the quantities of chloride, nitrogen and base which were secreted and to determine what, if any, aberrations from the normal occurred in cases of gastric disorder. In view of the observations of Bulger and Allen (3) presently to be discussed, it seemed of importance to find out whether deficiency of titratable acidity was due to an actual failure of chloride secretion or whether the mechanism for producing a relative deficiency of base was at fault. We also wished to determine whether any relation exists between the total amount of nitrogen in the gastric juice in health and in disease of the stomach and whether stimuli which affect acid secretion also influence the output of nitrogen. The present report deals primarily with methods and with the findings in a miscellaneous group of hospital patients; special condi-tions such as "anacidity " will be discussed in future papers. LITERATURE Only a few thorough analyses of human gastric juice are to be found in the literature, probably because of the difficulty of obtaining satis-611