A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
_Blood_ is often recognized by simple inspection, but more frequently
requires a chemic test. It is bright red when very fresh, and dark,
resembling coffee-grounds, when older.
_Particles of food_ eaten hours, or even days, previously, may be
found, and indicate deficient motor power.
{218} Search should always be made for _bits of tissue_ from the
gastric mucous membrane or newgrowths. These, when examined by a
pathologist, will sometimes render the diagnosis clear.
C. CHEMIC EXAMINATION
A routine chemic examination of the gastric contents involves
qualitative tests for free acids, free hydrochloric acid, and organic
acids, and quantitative estimations of total acidity, free
hydrochloric acid, and sometimes combined hydrochloric acid. Other
tests are applied when indicated.
1. Qualitative Tests.--(1) Free Acids.--The presence or absence of
free acids, without reference to the kind, is easily determined by
means of Congo-red.
* * * * *
Congo-red Test.--Take a few drops of a strong alcoholic solution of
Congo-red in a test-tube, dilute with water to a strong red color, and
add a few cubic centimeters of filtered gastric juice. The appearance
of a _blue color_ shows the presence of some free acid (Plate IX, B,
B'). Since the test is more sensitive to mineral than to organic
acids, a marked reaction points to the presence of free hydrochloric
acid.
Thick filter-paper soaked in Congo-red solution, dried, and cut into
strips may be used, but the test is much less delicate when thus
applied.
* * * * *
(2) Free Hydrochloric Acid.--In addition to its digestive function,
free hydrochloric acid is an efficient antiseptic. It prevents or
retards fermentation and lactic-acid formation, and is an important
means of protection against the entrance of pathogenic organisms into
the body. It is never absent in health.
* * * * *
{219} Amidobenzol Test.--To a little of the filtered gastric juice in
a test-tube, or to several drops in a porcelain dish, add a drop of
0.5 per cent. alcoholic solution of dimethylamido-azobenzol. In the
presence of free hydrochloric acid there will at once appear a
_cherry-red color_, varying in intensity with the amount of acid
(Plate X, C). This test is very delicate; but, unfortunately, organic
acids, when present in large amounts (above 0.5 per cent.), give a
similar reaction.
Boas' Test.--This test is less delicate than the preceding, but is
more reliable, since it reacts only to free hydrochloric acid.
In a porcelain dish mix a few drops of the gastric juice and the
reagent, and slowly evaporate to dryness over a flame, _taking care
not to scorch_. The appearance of a _rose-red color_, which fades upon
cooling, shows the presence of free hydrochloric acid (Plate IX, 1).
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