The bacterial content of the stomach as influenced by saliva

Abstract

The fractional method of gastric analysis makes possible a bacteriological study of the stomach which includes not only the active cycle of digestion, but the resting phase as well. So far as could be ascertained, no quantitative bacterial studies employing this method have heretofore been reported. In fact, very little data concerning the types of bacteria in the stomach at different stages of digestion have appeared in the literature beyond the work of Cotton. 1

In a previous paper, 2 the writer has shown that repeated analyses on the same individual within a short period of time—while the physical and mental condition remain practically unchanged—yield different curves. These curves from the same individual often vary as much from one another as the difference between the curves of different individuals. This holds true likewise for the average fasting contents. Therefore the conclusion was reached that single determinations by the Rehfuss method are not sufficient upon which to base valid conclusions since they do not take into consideration individual variations. In bacteriologic studies of fractional gastric analyses carried out repeatedly on psychotic patients and normal individuals, in only one half the instances was there any correlation between high acidity and low bacterial numbers or vice-versa. Upon close observation it became apparent that the amount of saliva swallowed by a patient during the two and one half hour period necessary for the complete gastric analysis by the fractional method, was of considerable significance. Only one patient, a case of profound depression, consistently showed a complete absence of bacteria on repeated analyses. Her mouth was usually exceedingly dry. The conclusion, therefore, was that the absence of saliva was the limiting factor, so far as her bacterial content was concerned.

It is manifestly impossible to completely prevent the swallowing of all saliva during the course of a fractional gastric analysis.