A CLINICAL STUDY OF DELAYED GASTRIC EMPTYING
Archives of internal medicine (Chicago, Ill. : 1908)
The object of our study was to determine the general incidence, and, as far as possible, the actual causes of delayed emptying of the stomach as met with in general practice. For this purpose we reviewed the records of 1,600 patients complaining of disturbances of digestion. Not all of these were suffering from actual lesions of the digestive tract. Many patients, as might be expected, had their primary source of trouble in other systems, such as the pulmonary, cardiorenal, or nervous. The
... r nervous. The diagnosis of delayed emptying was made from the evidence furnished by tube or Roentgen-ray examinations, or both. For the tube test, the patients were asked to eat an "ordinary dinner" of soup, potato, meat, bread and butter, and a simple dessert such as rice pudding. As substitutes for such a meal, where necessary, we employed a "breakfast" of eggs, toast and cereal, or a "light lunch" (omitting meat; otherwise the same as the dinner). A stomach residue obtained seven hours after the dinner,1 six hours after the lunch, or five hours after the breakfast, was regarded as pathological. The actual choice of food was always left to the patient, our purpose being to have him select a meal that he would ordinarily (namely, when well) dispose of without symptoms. Moreover, the patient was simply instructed to *Submitted for publication Jan. 12, 1916. 1. The reason for taking seven hours as the outer limit of the normal is, first, because it is known that the normal stomach digests food ordinarily considered difficult in less than six hours ; and secondly, because our meals are so arranged that rarely over six hours elapses between them. The normal stomach is no doubt capable of considerable latitude in the quantity of food it can hold. The weak or sick stomach, on the other hand, objects to undertaking the digestion of the new meal before it has disposed of the old. The symptoms may be due either to the increased load or to the disturbed chemistry, the gastric secretions at the end of digestion being different from what they are at the beginning.