We recently discussed the advantages of the "combined test" in obtaining controlled results in determinations of gastric acidity. The combined test embodies the direct study of gastric acidity and the simultaneous estimation of the urinary reaction. This test is based on the observation that persons having a relatively normal gastric secretion are prone to develop a less acid urine after meals, commonly referred to as the alkaline tide. On the other hand, patients with a true achlorhydria tend to show a relative fixation of the urinary reaction.
In our previous investigations, we employed histamine subcutaneously as the gastric stimulant. The fact that no more than 50 per cent of our patients, in whom free hydrochloric acid was demonstrated in the gastric extractions after the subcutaneous injection of histamine, developed a definite urinary alkaline tide caused us to abandon the use of histamine as the gastric stimulant in the combined test.
MATZNER MJ, GRAY I, GREENFIELD H. A TEST FOR GASTRIC ACIDITY: THE "COMBINED" TEST. Arch Intern Med (Chic). 1931;47(3):421–423. doi:10.1001/archinte.1931.00140210084008
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