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October 20, 1923


Author Affiliations

Consultant in Gastro-Enterology, U. S. Veterans' Bureau; Assistant Roentgenologist, Bellevue Hospital NEW YORK

JAMA. 1923;81(16):1341. doi:10.1001/jama.1923.02650160015004

Various methods have been devised for determining secretory derangements of the stomach, without the use of the stomach tube. One of the most interesting and generally accepted, through the prestige of authority, is the desmoid reaction of Herman Sahli.1 This test is based on the assertion of Adolf Schmidt that connective tissue is digested only in the stomach, and never in the small intestine. Sahli made use of this, by enclosing pills containing methylene blue in a small piece of rubber tissue, and tying this with catgut. This is swallowed by the patient. If the catgut is digested, the methylene blue is liberated and absorbed. Its excretion is noted in the urine. Presumably, this will occur only in the presence of gastric digestion and for no other reason.

If it can be demonstrated that the intestinal secretion also may play a part in the digestion of the catgut, the