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The use of gastric analysis as a diagnostic method has in recent years fallen under a cloud and, while descriptions of new modifications of test meals continue to appear, they receive at best a half-hearted reception. The reason for this is not far to seek. Variations in gastric secretion are so wide in healthy people that very little specific diagnostic information can be elicited in disease. It is true, to be sure, that many patients with duodenal ulcer have a highly acid gastric juice but the limit attained by the normal stomach after the conventional stimuli is not transcended (1). All one can say is that high acid is compatible with duodenal ulcer but not diagnostic. Very low acid or anacidity is strong evidence against duodenal ulcer, and this is perhaps the most valuable piece of clinical information to be obtained from gastric analysis. The anacidity which used to be thought so suggestive of cancer is now known to occur in many healthy elderly people (2); and the presence of acid even in large amounts by no means rules out neoplasms, especially those forms originating in a peptic ulcer (3). It occurred to us that potential differences in gastric secretion might be wiped out by powerful stimuli such as histamine which are in vogue in the clinic, and going a step farther we wondered whether measurements of the spontaneous gastric secretion obtained without the use of any stimulus might in disease show significant deviations from the normal and hence be useful in clinical diagnosis.

BASAL GASTRIC SECRETION AS A CLINICAL TEST OF GASTRIC FUNCTION WITH SPECIAL REFERENCE TO PEPTIC ULCER