DETECTION OF FREE ACID IN PATIENTS WITH SUSPECTED ANACIDITY

In examining a great number of patients with peptic ulcer or with subtotal gastrectomies, one is often faced with the problem of an apparently complete anacidity and a lack of response of the acid secretion of the stomach even to histamine, in patients who complain about heartburn, belching of sour material, and the like. Sometimes examination of the stomach contents of such persons right after sampling but before filtration reveals a strong positive reaction for free acid (Topfer's reagent) on the surface of the mucous material only. This soon disappears, especially after filtration. Such cases cannot be called anacid but under the conditions of an ordinary stomach test would so appear. Evidently the little free hydrochloric acid that is present combines quickly with the mucus, which in most of these cases is abundant. In other cases, regurgitation from the duodenum is the neutralizing factor. We therefore devised a method by