The problem of gastric acidity has interested us for some time. An analysis of the different methods for studying gastric acidity reveals certain disadvantages and inaccuracies. Our attention has been particularly focused on the problem because of the conflicting observations in patients with partial gastrectomies. In these patients, the factor of regurgitation of alkaline intestinal secretions is an important consideration.
DIRECT METHODS
We feel that the stimulation of gastric secretion by the ordinary test meals in use (gruels, crackers, water, etc.) is uncertain and variable. Psychic elements, such as appetite or distaste for food, speed of eating and quantity of saliva are factors that make accurate results difficult. Babkin1 recently emphasized the influence of the secretion of mucus on gastric acidity. Furthermore, the ingestion of a meal does not always afford a maximum stimulus, as is noted in those patients who appear to have anacidity, but who subsequently secrete hydrochloric