The signs of internal disease, with a brief consideration of the principal symptoms thereof . r function of thestomach, the presence or absence of abnormal substances and the-products of gastric digestion, has approached almost to a routine pro-cedure. After fasting all night, or, better, after washing out the -298 EXAMINATION OF THE STOMACH CONTENTS stomach, the patient is given a test-breakfast. Ewalds is simplestand most used, consisting of an ordinary bakers roll eaten dry, and300 of weak tea, without milk or sugar, or a like quantity of warmwater. Such a meal contains little or no la
The signs of internal disease, with a brief consideration of the principal symptoms thereof . r function of thestomach, the presence or absence of abnormal substances and the-products of gastric digestion, has approached almost to a routine pro-cedure. After fasting all night, or, better, after washing out the -298 EXAMINATION OF THE STOMACH CONTENTS stomach, the patient is given a test-breakfast. Ewalds is simplestand most used, consisting of an ordinary bakers roll eaten dry, and300 of weak tea, without milk or sugar, or a like quantity of warmwater. Such a meal contains little or no lactic acid, the presenceof which is the objection to most proposed test-meals. The Boas test-meal, consisting of a gruel made of a tablespoonful of oatmeal boiledin a litre of water, may be used for estimating lactic acid. One hourafter ingestion the residue is removed with the stomach tube andexamined. The residue should be about 40 c. e. After noting thequantity, odor, color, consistence, and amount of mucus, a small por-tion is examined with the microscope to determine the nature of the. Fig. 70—Stomach Tube with Syphon Bulb. .residue and the presence of anatomic elements. The remainder is well-shaken, filtered, and the clear filtrate tested as;soon as possible. Reaction. The normal reaction of the gastric juice is decidedly -acid, due to hydrochloric acid, acid salts (NaH^PO^), occasionally toorganic acids and carbonic acid. During digestion free organic acids,acid albumins, consisting of combinations of hydrochloric acid andorganic acids with the proteids of the food, and the acid salts (acid iSodiXim and acid potassium phosphates) also add to the acid should not be present after the oatmeal breakfast. Its -sources are, fermentation of the stomach contents due to retention— ^deficiency of the motor function and to pyloric obstruction—and tothe introduction of sarcolaetic acid into the stomach with foods. Butyric and acetic acid are fermentation products
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