Excerpt from The Chemical Investigation of Gastric and Intestinal Diseases: By the Aid of Test Meals

It is practically impossible to diagnose many of the functional diseases of the stomach from the symptoms alone, and the clini cian who does not call chemical tests to his aid is bound to mass together under one or another heading, various functional dis orders which ought to be kept entirely separate. Thanks to the introduction of the stomach-tube, one is now able to obtain the contents of the stomach, and find out what Chemical changes, if any, are present, thus enabling one to draw conclusions as to the sub-division of the various functional diseases of the stomach.

In organic diseases of the stomach, chemical analysis is not nearly so important, since in these there are several signs and symptoms which point in one. Direction or the other.

It must be understood that the results obtained from the chemi cal analysis of the gastric contents can never alone be sufficient for the formation of a definite diagnosis of the various forms Of gastric dyspepsia; each case has to be carefully considered in connection with the various symptoms and physical Signs present, and the stomach analysis is merely to be regarded as an aid in making a more careful and detailed diagnosis.

The idea that any one chemical factor is pathognomonic of any Special condition must also be at once put aside; The diagnosis of carcinoma of the stomach from the absence of free hydrochloric acid in the gastric secretions has now to be regarded as non-conclusive, unless the history and physical Signs support the diagnosis. This is analogous to the fact that the presence of albumen in the urine is not pathognomonic of Bright's disease unless one has negatived its attribution to cardiac, digestive, or other causes, and has, in support of the Bright's disease theory, various other symptoms with possibly other chemical results, which point in that direction. The fact that albumen is not pathognomonic of Bright's disease does not, however, detract from the value of the urine analysis.

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