Tubeless gastric analysis.

During 1950-3 Segal and his colleagues (Segal, 1951 ; Segal, Miller, and Morton, 1950, 1952, 1953; Segal, Miller, Morton, and Young, 1950) have published the results of their investigations of the hydrochloric acid content of the gastric juice by an original method which does not require the passing of a Ryle's stomach tube. This elegant technique depends upon the power of the hydrogen cation (H+) of the free hydrochloric acid of the gastric juice, at a pH of 3 or less, to displace the quininium cation (QH+) from a quininiumresin indicator compound; the quinine hydrochloride now formed is rapidly absorbed from the small intestine and quinine is excreted in the urine where it appears within 15 minutes of the ingestion of the resin; the quinine is readily estimated quantitatively in the urine by a simple method based on its fluorescence in ultra-violet light. Our interest in Segal's method arose from a brief note in the Lancet (Segal et al., 1952) reporting the second national cancer conference in the U.S.A. This is apparently the only reference so far in the British literature. The details in the original papers suggested to us that the technique had such potential value that we decided to investigate the problem also. Material and Methods Segal's quininium-resin indicator is available in America as a commercial product under the trade name of "diagnex-QH " or " diagnex," but it is not yet sold in Britain. Although the method of preparation was not given completely in any of Segal's papers, one of us was able to prepare an equivalent product using the quinine hydrochloride and " amberlite XE-96 "* which we could obtain in this country. The co-operation of the clinicians of this area was obtained for an investigation by this new method on every patient to whom the alcohol testmeal was given. In addition to this consecutive