THE DIAGNOSTIC VALUE-OF DETERMINATIONS OF PEPSIN IN GASTRIC JUICE

In previous papers (1) we described-a method for the measurement of pepsin in gastric juice and reported the results of determinations made at frequent intervals before and after stimulation of the stomach secretions by histamine. It was shown that the concentration of pepsin falls after stimulation although the total output of ferment is increased at the height of secretion. It was also pointed out that the curve of pepsin concentration closely parallels that of nitrogen con-centration. Finally, a few cases of anacidity were reported in which, however, pepsin was still demonstrable. In the previous communication the general range of pepsin output was indicated but not enough cases had been studied to set actual standards. The present paper deals with an analysis of a larger series of observations and with the diagnostic implications derived therefrom. MATERIAL AND METHODS Forty determinations were made on thirty-six hospital patients. Of these, twenty-one showed no evidence of disease of the stomach and were essentially normal people, five had duodenal ulcer, one had gastric ulcer, five had cancer of the stomach, two had pernicious anemia, one had sprue and two had anacidity for which no explanation was found. The determinations were made by the method previously described (2) on samples of gastric juice collected over ten-minute periods after histamine stimulation. The results are recorded in terms of milligrams of edestin digested by 1 cc. of gastric juice. RESULTS Chart 1 shows the shape of the curves of pepsin concentration and of total output of pepsin per ten-minute period after histamine stimula-10