Abstract
Aliquot fractions obtained by the Rehfuss method of fractional gastric analysis do not accurately represent the total gastric contents, as indicated by the results of the following experiments on subjects showing no clinical evidence of gastric disease:
1. Instead of the usual periodic aspiration, the total gastric contents were removed after three quarters of an hour by withdrawing 10 c.c. fractions in rapid succession. A wide variation was found in the acidity of these fractions, indicating that the total gastric contents are not a homogeneous mixture and that a single 10 c.c. sample is not a valid aliquot. This was more noticeable in subjects having a high rather than low gastric acidity.
2. (a) By inserting three Rehfuss tubes in one individual and aspirating the fractions simultaneously at fifteen minute intervals, it was found that there was considerable variation of acidity in different parts of the stomach at the same moment. X-ray pictures established the relative position of the tubes.
(b) From these data it is shown that widely divergent curves of acidity may be plotted which depend entirely upon the experimental error of the method and not upon the subject's gastric condition.
(c) The inadequacy of the titration method and the importance of hydrogen ions and buffer salts in measuring gastric acidity is indicated.
3. A subject who could regurgitate his total gastric contents at will, was given the test meal on different days and the total contents were regurgitated at different intervals from the time of ingestion to the test meal. The curve of acidity plotted in this manner differed radically from the curve obtained in the usual manner. Furthermore, discrepancies were noted between the acidity of an aliquot removed immediately prior to regurgitation and the acidity of the total gastric contents.
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