The Gastrograph : 
A New Means of determining 
the Mechanical Action of 
the Stomach. 
BT 
MAX EINHORN, M. D. 
REPRINTED PROM THE 
Xeto Ytsxfc J£eWcal journal 
for September 15, 1894. Reprinted from the New York Medical Journal for September 15, 1894. 
THE GASTROGRAPH: 
A NEW MEANS OF DETERMINING THE MECHANICAL ACTION OF THE STOMACH.* 
MAX EINHORN, M. D. 
Under mechanical action of the stomach one under- 
stands the changes which substances there undergo by the 
existing motions of this organ. 
At the end of the last century, when physiology began 
to develop, several theories of the physiological function of 
the stomach took their origin. The oldest of these theo- 
ries and the one which enjoyed most recognition was that 
of trituration, the food in the stomach being broken into 
small particles and changed into chyme. In the stomach 
of birds—where glass beads experimentally introduced were 
found, as you all know, broken into small fragments—one 
saw' the proof for the correctness of the mechanical theory. 
Even then, however, before the chemical qualities of the 
gastric juice were known, two other theories had been con- 
structed—the fermentative and the chemical. The advo- 
cates of the fermentative theory explained the digestive act 
as a kind of decomposition of the food by a putrid-like 
process. The chemists, however, looked for the active 
principle in the saliva and in the gastric juice, 
Haller f believed that the food only became softened 
and diluted by the gastric juice, the process of maceration 
being aided and accelerated by the warmth, the putrefactive 
principle, and the slight but continuous motions to which 
the aliments are subjected. 
Reaumur and Spallanzani J endeavored to bring light 
upon this subject by way of ingenious experiments. They 
had animals swallow wooden capsules filled with food 
(meat), the capsules having several holes so as to admit 
the gastric juice into them. After a few hours the animals 
were killed, the stomach opened, and the capsules ob- 
tained ; they were always found empty—i. e., the meat had 
been digested. This experiment unmistakably showed the 
important part of the gastric juice for digestion. The 
other theories seemed thus to be overthrown, and the 
chemical alone to be the right one. 
The mechanical action of the stomach from that time 
on until the end of the first quarter of this century was con- 
sidered of hardly any value. 
Thus Magendie * describes the act of gastric digestion in 
the following way: 
“ The aliment remains in the stomach generally about 
one hour before it undergoes any perceptible change, but 
what arises from its mixture with the fluids which are con- 
stantly poured into this organ. During this time the stom- 
ach remains uniformly distended; at last the pyloric por- 
tion contracts itself, through its whole extent, especially 
toward the point nearest to the cardiac portion, during 
which the aliments are forced back. From this time we 
find in the pyloric portion nothing but chyme mixed with 
a very small portion of aliment unchanged.” 
Johannes Muller* shares the same view, as can be seen 
from his following remarks : 
“ Only irritants applied directly to the stomach cause an 
immediate contraction. It is evident how mistaken those 
are who count much on the motions of the stomach for the 
dividing of the food into small particles. The peristaltic 
motions of the stomach I have never seen clearly. I there- 
fore describe them after Magendie.” 
Richerand f emphasizes that the principal part of diges- 
tion is not performed in the stomach: “ L’estomac ade 
tout temps ete regarde comme le principal organe de la 
digestion; il n’y joue cependant qu’un role preparatoire et 
secondaire.” 
This author utilizes all the three theories in explaining 
the function of the stomach. He expresses himself as fol- 
lows : J 
“The soft and peristaltic action of the muscular fibers 
of the stomach exercises a slight pressure on the alimentary 
substances and triturates them finely. At the same time 
the gastric fluids soften and macerate the aliments before 
dissolving them. One might say that the process of gas- 
tric digestion is at the same time.chemical, mechanical, and 
vital. In this way the authors of the different theories of 
the gastric mechanism have been wrong only inasmuch as 
they attributed this latter to one cause—namely, the warmth, 
the putrefaction, the trituration, the maceration, the gastric 
juices—instead of explaining it as an act of all these causes 
united.” 
A new era in the physiology of gastric digestion begins 
with Beaumont.* His classical experiments on the Ca- 
* Read before the Medical Society of the County of New York, 
May 28, 1894. 
| Haller. Elementa physiologies, Bd. vi, Bernae, 1'764. 
+ Spallanzani. Versuche über das Verdauungsgeschaft, Abhand- 
-1 ung YI. 
# F. Magendie. A Summary of Physiology, Baltimore, 1824, p. 228. 
*J. Miiller. Handbuch der Physiologic des Menschen, 1837-1840, 
p. 483. 
■f Richerand. Nouveaux Siemens de physiologic, Paris, 1825, t. i. 
\ Richerand. Loc. cit., p. 234. 
#W. Beaumont. Experimental Observations',on the Gastric Juice. 
Combe’s Edition. 
Copyright, 1894, by D. Appleton and Company. THE GASTROGRAPH. 
nadian St. Martin with the gastric fistula, executed during 
a period of several years, have greatly advanced all those 
important questions referring to the function of the stom- 
ach and remained undisputed to date. Beaumont knew the 
chemical properties of the gastric juice and gave a detailed 
description, from his own observations made on the Ca- 
nadian, of the motions of the stomach and of the food. To 
illustrate Beaumont’s views, we cite the following sen- 
tences* from his well-known book Experimental Observa- 
tions on the Gastric Juice : 
their chymification; thirdly, to act dynamically—namely, 
to mix the food and to expel it in the state of chyme. . . . 
“ Finally, the last quality attributed to the stomach is 
that of exercising a mechanical action on the aliments by 
means of the peristaltic movement with which it is pro- 
vided.” 
M. Schitf, * on the contrary, attributes very little impor- 
tance to the motions of the stomach. He says : 
“ Formerly much importance was attributed to the me- 
chanical phenomena of the gastric digestion. By means of 
them one explained the maceration and even the dissolution 
of the aliments, and constructed strange hypotheses relating 
to the muscular force of the stomach. One even expressed 
in figures the supposed “ enormous force ” of the spiral 
fibers of this organ. Spallanzani and Reaumur, however, 
had already produced artificial digestions, and had proved 
by their experiments that the aliment need not be in im- 
mediate contact with the stomach wall in order to become 
liquefied and digested, . . . and we are entitled to say that, 
as a whole, in all mammals—including man,—it is the gas- 
tric juice alone which performs the gastric digestion.’1'1 
“ That chymification is effected by the solvent action of 
the gastric juice, aided by the motions of the stomach, and 
the natural warmth of the system, not a doubt can remain 
in the mind of any person who has had an opportunity to 
observe its effects on alimentary substances. 
“ . . , These motions not only produce a constant dis- 
turbance, or churning of the contents of this organ, but 
they compel them at the same time to revolve around the 
interior from point to point, and from one extremity to the 
other. In addition to these motions there is a constant 
agitation of the stomach produced by the respiratory mus- 
cles.” Page 102 : “ While these revolutions of the con- 
tents of the stomach are progressing, the trituration or agi- 
tation is also going on. There is a perfect admixture of 
the whole ingesta.” 
The later physiologists have occupied themselves but 
very little with the subject in question. In this way one 
finds in most text-books either the description given by 
Beaumont or Schiff’s opinion. 
The movements of the food, according to Beaumont, 
take place in the following way : 
WThereas the experiments referring to the mechanical 
action of the stomach were left on the shelf, numerous in- 
vestigations had been made in regard to the removal of the 
contents from the stomach into the intestines. This point 
“ The ordinary course and direction of the revolutions 
of the food are, first, after passing the oesophageal ring. 
from right to left, along the small arch, thence 
through the large curvature from left to right. 
The bolus as it enters the cardia turns to the left, 
passes the aperture, descends into the splenic ex- 
tremity, and follows the great curvature toward the 
pyloric end. It then returns in the course of the 
smaller curvature, and makes its appearance again 
at the aperture in its descent into the great curva- 
j. ______ i i • rm 
ture to perform similar revolutions. These revo- 
lutions are completed in from one to three minutes. 
Fig. I.—The ball apparatus of the gastrograph. (Natural size.) 
. . . . The bulb of the thermometer, which has been fre- 
quently introduced during chymification, invariably indi- 
cates the same movement. They are slower at first than 
after chymification has considerably advanced.” 
alone during the last twenty years took the foremost in- 
terest, the more so since one had learned to utilize it in 
pathological conditions. According to Leube,f the stomach 
normally is empty seven hours after a substantial meal. 
Wherever this is not the case one speaks of a “ faulty mo- 
tion ”of the stomach. One became accustomed to use the 
term “ motility ” for the transportation of food from the 
stomach into the intestines, leaving the mechanical action 
of the stomach without any consideration whatever. The 
transportation faculty of the stomach considerably gained 
in importance, since it has been proved, by experiments 
made on dogs by Mering,| Moritz,* and Ilirsch, || that the 
absorption of liquids through the stomach wall hardly 
amounts to anything. 
W. Brinton f corroborated most of these facts by fur- 
ther experiments on animals and explained the admixture 
of the food in the stomach by the two existing different 
currents—one in the center, the other in the periphery of 
this organ. 
Blondlot J takes the same view as Richerand, laying, 
however, more stress on the mechanical action of the stom- 
ach, as may be seen from the following extracts: 
“ The stomach, as a whole, has to fulfill a triple role : 
Firstly (the most essential), to secrete the chymifying 
fiuids; secondly, to serve as a receptacle for food during 
Kussmaul, the founder of modern stomach pathology, 
fW. Brinton. Contributions to the Physiology of the Alimentary 
Canal. The London Medical Gazette, 1849, viii, p. 1025. 
* Beaumont. Loc. cit., p. 101. 
*M. Schiff. Physiologic de la digestion, 1867, t. i, p. 354. 
| Leube. Die Krankheiten des Magens und Darms. 
t Mering. Munchener med. Wochenschrift, Sept. 19, 1898, p. 721. 
* Moritz. Ibid. 
\ Blondlot. Traite analytique de la digestion, Paris, 1843, pp. 
187-189. 
I Hirsch. Ctrlbl. fur Min. Med., 1898, No. 18. THE GASTRO GRAPH. 
3 
has written a very important paper touching our subject. 
His article on Peristaltic Restlessness of the Stomach forms 
a chapter of the pathology of the mechanical as well as of 
the transporting action of the stomach. We cite from Kuss- 
maul * the following sentences : 
chanical action of the stomach plays in the churning of the 
food. This point has been least worked upon. 
It appeared to me of interest to make investigations on 
the subject in question. For several years I have been 
looking for some methods which would allow us to judge 
approximately of the mechanical action of the stomach. 
AII usual methods of examining the motor faculty of the 
stomach can not be utilized for our object in view, for they 
all only consider the transportation of the contents, but not 
the motor work done by the stomach itself all the time. 
As the motions of the stomach necessarily cause a shaking 
of its contents, I tried to introduce into this organ sepa- 
rately two emulsifiabJe substances, and to withdraw them 
half an hour later by means of the tube; the idea was that 
the shaking would produce an emulsion. The tests, how- 
ever, showed that generally there was no emulsion. At any 
rate, these experiments did not permit of any estimate of 
the mechanical action and were thus unfit for our purpose. 
Later on I tried to judge the contractions of the stomach 
by means of the stomach bucket; * the latter being within 
the stomach, one can observe how far, with what force, and 
at what intervals the thread on which the bucket hangs is 
pulled farther in. The thread alone affords too few sup- 
porting points to be moved by the contractions of the 
oesophagus. In this way every traction of the thread hints 
at a further locomotion of the bucket in the stomach. This 
method, however, is deficient for the reason that the, mo- 
tions of the bucket in the stomach will not be recognized as 
soon as a longer piece of thread has reached this organ. 
“ The peristaltic motions of the stomach in man, as a 
rule, remain concealed. Only under favorable conditions, 
if the abdominal walls are very thin and the stomach either 
situated very low or dilated, they become visible. But even 
then not always. On the other hand, in some persons we 
see the peristaltic motion in a picture, which I designate as 
‘ peristaltic restlessness.’ Here the peristaltic action is 
remarkably lively; the mountain waves which move over 
the stomach are large and powerful. Rest appears only 
when the stomach is empty from food and contains only 
air, or not even then.” 
In most of these patients there is a dilated stomach, 
with hypertrophied muscularis, in consequence of a stenosis 
either of the pylorus or of the duodenum. The peristaltic 
restlessness is, then, the result of a visible mechanical re- 
sistance ; but it is also met with in cases without stenosis 
as the consequence of an increased irritability of the peri- 
staltic nerve apparatus of the stomach. At another place 
in his article Kussmaul says : “ The nervous peristaltic rest- 
lessness of the stomach is perhaps more frequent than it 
appears and not necessarily associated with dilatation. One 
merely can not perceive the motions of the stomach having 
its normal size and position. Even if the stomach is situ- 
ated low, the motions can only be recognized in people with 
thin and relaxed abdominal walls,” 
Regarding the effect of the muscles of the stomach 
on the digestive process, Leube f expresses himself as fol- 
lows : 
“ If one persuades himself of the effect which shaking 
produces in digestive fluids in test tubes, dissolving quick- 
ly substances contained therein, he will very easily conceive 
the importance of the gastric motions in this respect. By 
the contractions of the stomach wall the chyme apparently 
comes in contact with it at different places and becomes 
saturated with its juice. Likewise the contact of gastric 
contents witli the stomach wall is fit to mechanically pro- 
duce secretion anew.” 
C. A. Ewald \ very recently has made researches upon 
the motions of the chyme in the stomach, resembling those 
of Beaumont, on a patient with gastric fistula. We cite 
from Ewald the following : “ I have gained the impression 
that the concussion of the stomach contents—which may 
be compared with the shaking of a sieve in the mill—serves 
as a very important factor in the mechanical admixture and 
the dissolution of the food stuffs.” 
In summing up the above-mentioned literature, it is 
evident that the stomach shows peristaltic motions and that 
they may be pathologically increased. There is, however, 
a discordance of opinion referring to the part which the me- 
Fig. 2.—Cross section of the ball, showing its interior construction. (Enlarged 
three and a half times.) a, the two hemispheres ; b, the spiked hall; c, the 
platinum ball. 
Having the fact in view that, by the active (peristaltic) 
and passive (transmitted respiratory and pulsatory) motions 
of the stomach, there occurs a moving and at the same 
time shaking of the contents—which is the expression of 
the mechanical action—l have constructed an apparatus 
which indicates every motion to which it may be subjected 
*A. Kussmaul. Yolkmann’s Sammlung klinischer Vortrage, No. 
181, Jnni, 1880, p. 163 Y. 
\ Leube. Pie Krankheiten dcs Magens und Parms, von Ziemssen, 
Bd. vii, p. 19. 
\C. A. Ewald. Zeitschrift f. klin. Median, Bd. xx, p. 547. 
* Max Einhorn. Medical Record, July 19, 1890. 4 
THE GASTRO GRAPH. 
The whole apparatus comprises : 1. The hall (being the prin- 
cipal part), 2. A few electric cells. 3. The ticker. 
touch the spike any more the current is broken. At each 
motion of the ball apparatus a rolling of the little platinum 
ball takes place and the electric current is either closed or 
broken. When the apparatus is at rest there is no change 
in the current. In connecting the “ticker” with the bat- 
tery and the ball, each motion of the latter will be recorded 
The ball (Fig. 1) consists of two hollow metallic hemi- 
spheres (a), which are screwed together ; within it is lodged 
and attached to the upper hemisphere, but perfectly insu- 
lated from the same at the attachment, another ball pro- 
on the paper in showing the 
“ breaks ” and “ makes ” of 
the current. 
If the ball is swallowed 
and brought into the stom- 
ach, the motions of it— 
which are caused by the ac- 
tive and passive motions of 
the stomach—can be re- 
corded in the same way as 
described. 
therefore be designated as 
This apparatus may 
“ Gastrokinesograph,” or, 
shorter, “ Gastrograph,” * 
From numerous tests 
which I have made, it ap- 
pears with certainty that the 
gastrograph works in the 
desired manner—i. e., it in- 
dicates the motions of the 
ball and can thus be utilized 
for the valuation of the mo- 
tions of the stomach or the 
mechanical action of this 
organ. 
Method.—The ball is 
dipped in lukewarm water, 
introduced into the pharynx 
of the patient, and the latter 
told to swallow. The pa- 
tient may drink some water. 
After a short while (from a 
minute to a minute and a 
half) the ball reaches the 
stomach. It is advisable 
to let the ball slip far down 
into the stomach, so that 
the distance from the mouth 
I tg. 3.—-A patient undergoing examination with the gastrograph, 
to the ball (length of cable) 
is about fifty centimetres. 
The cable is then connected 
vided with spikes (b) radiating in all directions, but not 
touching the inside walls of the hemispheres; another very 
small platinum ball (c) lies within the large ball and can 
freely move in all directions, knocking at the spikes. (See 
Fig. 2.) Two insulated wires—one connected with the hol- 
low ball, the other with the spiked ball—are incased in a 
very fine, thin rubber tube, forming the cable, and separate 
at the end into two branches, which must be attached to an 
electric battery. As soon as the platinum ball touches one 
of the spikes an electric circuit is made; as soon, how- 
ever, as the platinum ball moves a little aside and does not 
with the battery and the indicator and the latter set ago- 
ing for three minutes (Fig. 3). The patient during this 
procedure sits quietly on a comfortable chair. At the end 
of three minutes the indicator is checked, the cable discon- 
nected from the battery, and the ball withdrawn from the 
stomach. When at the introitus oesophagi, it is necessary, 
here in the same way as when using the bucket f or the 
deglutable electrode, to have the patient swallow, and to 
* The gastrograph may be obtained of Richard Kny & Co., 17 Park Place. 
Max Einhorn. Medical Record, July 19, 1890. THE GASTROGRAPH. 
Table 
I- 
-GASTROGRAMS OF HEALTHY INDIVIDUALS. 
1. 
2, 
3 (minutes). 
No. 
Name. 
Date. 
Condition. 
Number of 
dots. 
1. 
3. 
5. 
7. 
9. 
11. 
13. 
15. 
17. 
19. 
21. 
23. 
25. 
27. 
29. 
1. 
Dr. A. R. 
Jan. 10, 
1894. 
When fasting + one glassful of 
water. 
. 
14 + 4 + 5=23. 
2. 
Dr. A. E. 
Mar. 38, 
1894. 
One hour after the test breakfast 
+ i a glassful of water. 
11 + 16 + 6=33. 
3. 
Carl G. 
Feb. 23, 
1894. 
When fasting, without any 
water. 
1 + 1+3=4. 
4. 
Carl G. 
Feb. 23, 
1894. 
When fasting + | a glassful of 
water. 
’ 
1 + 2 + 2=5. 
5. 
Carl G. 
Jan. 28, 
1894. 
An hour and a quarter after a 
light breakfast, without any 
water. 
/. . 
12 + 17 + 12=41. 
6. 
Carl G. 
Jan. 12, 
1894. 
Two hours after breakfast + 1 
glassful of water. 
3 + 6 + 7=16. 
7. 
Carl G. 
Feb. 25, 
1894. 
An hour and three quarters after 
breakfast + $ a glassful of 
water. 
2 + 2 + 7=11. 
8. 
Carl G. 
Feb. 25, 
1894. 
Do. (Further 3 minutes.) 
. 
i 
6 + 4 + 4=14. 
5 
utilize the moment, when the lar- 
ynx goes upward and forward, to 
withdraw the ball without using 
any force whatever. 
E. C. A., Table 11, Case YI, 8„ 
Dr. A. R., Table I, 2. 
H. R., Table 11, Case 11, 2. 
The strip of paper which has 
rolled off from the reel is cut off 
and the marks are then perused. 
The black line shows when the 
current was closed, the empty 
places when there was no cur- 
rent. As an instance I give a 
few gastrograms (reduced ten 
times) (Fig. 4). For my experi- 
ments I have found it practical 
to enter the marks of the strips 
intq a copy book. This was done 
in the following way : Each line 
was divided into three equal 
spaces—each space correspond- 
ing to one minute—each space 
(or minute) into ten divisions, and 
the “ breaks ” and “ makes ” of 
the current marked with dots at 
the corresponding place. In this 
way the number of current 
changes can very easily be looked 
over and comparisons made. 
(A) Physiological. I have 
made several tests with the gas- 
trograph on healthy people and 
describe them in Table I, 
These experiments show that 
the stomach is not so inactive 
mechanically as several authors 
believed, and that it churns the 
contents almost continuously with 
slight periodical interruptions. 
The number of motions for 
three minutes averaged from four 
to forty-one. 
When fasting, the mechanical 
action of the stomach seems to be 
much less than after meals. One 
hour after a light breakfast the 
gastrograph marked thirty-three 
in the case of Dr. A. It. 
My experiments on healthy 
people are not numerous enough 
and will have to be largely supple- 
mented. 
(B) Pathological.—Most pa- 
tients had been examined with 
the gastrograph either when fast- 
ing or from an hour to an hour 
and a half after the test break- 
fast, taking about half a glass- 
ful of water when swallowing 
the ball; many of the patients 
have been examined under both 
Fig. 4 6 
THE GASTRO GRAPH. 
No. 
Name. 
Disease. 
Date. 
Condition. 
1. 
2. 
3 (minutes). 
Number of 
dots. 
1. 
i ' ; i I 
3. j 5. j 7. 9. 
11. 
13. 
15. 
17. 
19. 
21. 
23. 
25. 
27. 
29. 
• 
15 + 11 + 10=36. 
16 + 8 + 7=31. 
9 + 7 + 3=19. 
6 + 9 + 6=21. 
10 + 5 + 0=15. 
9 + 6 + 5=20. 
13 + 14 + 3=80. 
4 + 14 + 15=33. 
5 + 5 + 4=14. 
/ 
3 + 6 + 8=17. 
14 + 14 + 12=40. 
0 + 3 + 19=22. 
0 + 12 + 0=12. 
13 + 14 + 12=39. 
33 + 28 + 22= 83. 
9 + 3+28=40. 
17 + 14 + 1=32. 
5 + l + 0=6. 
11+0+0=11- 
I, 
1. 
II, 
2. 
III, 
3. 
4. 
5. 
IV, 
6. 
V, 
7. 
VI, 
8. 
VII, 
9. 
VIII, 
10. 
x, 
11. 
12. 
X, 
13. 
XI, 
14. 
XII, 
15. 
XIII, 
10. 
17. 
18. 
19. 
Dr. D. 
H. R. 
H. B. 
Do. 
Do. 
H. S. 
Augusta 8. 
Edward C. A. 
B. 8. 
H. F. 
Friedrich G. J. 
Do. 
N. C. 8. 
Max B. 
William U. 
Rev. 8. 
Do. 
Do. 
Do. 
Dilatatio ven- 
triculi; hyper- 
aciditas. 
Gastritis gland, 
chron. 
Dilatatio ven- 
triculi; hyper- 
aciditas. 
Do. 
Do. 
Gastritis gland, 
chron. 
Do. 
Dilatatio ven- 
tricuh; hyper- 
acid! tas. 
Gastralgia. 
Gastro-succor- 
rhoea continua 
chron. 
Carcinoma 
pylori; “peri- 
staltic restless- 
ness of the 
stomach.” 
Do. 
Ectasia ventri- 
culi; stenosis 
pylori ex cica- 
trice ; hyper- 
aciditas. 
Excessive ano- 
rexia; neurotic 
trouble of the 
stomach. 
Ectasia ventri- 
culi; stenosis 
pylori ex cica- 
trice ; hyper- 
aciditas. 
Boulimia; 
hyperaciditas. 
Do. 
Do. 
Do. 
Jan. 13, 
1894. 
May 12. 
1894. 
Jan. 8, 
1894. 
Feb. 25, 
1894. 
Mar. 25. 
1894. 
Feb. 7, 
1894. 
May 7. 
1894. 
Mar. 26, 
1894. 
Jan. 21, 
1894. 
Jan. 15, 
1894. 
Feb. 2, 
1894. 
Mar. 23, 
1894. 
Feb. 15, 
1894. 
Feb. 1, 
1894. 
May 21, 
1894. 
Mar. 14, 
1894. 
Mar. 18, 
1894. 
Mar. 20, 
1894. 
Mar. 20, 
1894. 
Two hours after 
dinner + £ a glass- 
ful of water 
One hour after test 
breakfast + i a 
glassful of water. 
After washing of the 
stomach +-1 glass- 
ful of water. 
An hour and a half 
after a cup of cof- 
fee + j a glassful 
of water. 
When fasting + i a 
glassful of water. 
When fasting + | a 
glassful of water. 
An hour after the 
test breakfast + J 
a glassful of wa- 
ter. 
An hour and a quar- 
ter after the test 
breakfast + i a 
glassful of water. 
Two and a half 
hours after the 
test breakfast + i 
a glassful of wa- 
ter. 
When fasting + J of 
a glassful of water. 
After washing of 
the stomach +- £ a 
glassful of water. 
When fasting + 1 a 
glassful of water. 
After washing of 
the stomach + | a 
glassful of water. 
Three hours after 
test breakfast + 1 
a glassful of water. 
An hour and a half 
after the test 
breakfast + j- a 
glassful of water. 
Two hours after the 
test breakfast + 1 
a glassful of wa- 
ter. 
An hour and three 
quarters after the 
test breakfast + i 
a glassful of water. 
One hour after the 
test breakfast + 4 
a glassful of wa- 
ter. 
Three hours after 
the test breakfast 
+ | a glassful of 
water. 
Table IL—GASTROGRAMS OF PATIENTS WITH STOMACH TROUBLES. THE GASTROGRAPH. 
7 
1. 
2. 
3 (minutes). 
Number of 
dots. 
No. 
Name. 
Disease. 
Date. 
Condition. 
1. 
3. 
5. 
7. 
9. 
11. 
13. 
15. 
17. 
19. 
21. 
23. 
25, 
27. 
29. 
XIV, 
80. 
21. 
23. 
23. 
24. 
35. 
26. 
27. 
28. 
29. 
30. 
XV, 
31. 
32. 
XVI, 
33. 
34. 
35. 
XVII, 
36. 
87. 
XVIII, 
38. 
39. 
40. 
Adolph 8. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Frank G. 
Do. 
Edwin N. D.* 
Do. 
Do.t 
Fredrick W. 
Do. 
Robert F. 
Do. 
Do. 
Gastro-succor- 
rhoea continua 
chron.; hyper- 
aciditas; hyper- 
kinesis. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Gastro-succor- 
rhoea continua 
periodica (dur- 
ing the attack). 
Do. 
Atonia ventri- 
culi; dilatatio. 
Do. 
Do. 
Gastritis gland, 
chron.; dilatatio 
ventriculi. 
Do. 
Dilatatio ven- 
triculi ; hyper- 
aciditas. 
Do. 
Do. 
Mar. 8, 
1894. 
Mar. 8, 
1894. 
Mar. 4, 
1894. 
Mar. 11, 
1894. 
Mar. 11, 
1894. 
Mar. 15, 
1894. 
Mar. 8, 
1894. 
Mar. 18, 
1894. 
Apr. 8, 
1894. 
Apr. 15, 
1894. 
Apr. 39, 
1894. 
Feb. 23, 
1894. 
Feb. 25, 
1894. 
Apr. 25, 
1894. 
Apr. 28, 
1894. 
May 5, 
1894. 
Apr. 1, 
1894. 
Apr. 1, 
1894. 
Mar. 22, 
1894. 
Mar. 25, 
1894. 
Apr. 15, 
1894. 
When fasting + }a 
glassful of water. 
Twenty minutes af- 
ter the test break- 
fast +1 a glassful 
of water. 
Three quarters of an 
hour after the test 
breakfast + i a 
glassful of water. 
When fasting + i a 
glassful of water. 
Twenty-five minutes 
after the test 
breakfast + a 
glassful of water. 
When fasting + j a 
glassful of water. 
Two hours after the 
test breakfast + 4 
a glassful of water. 
One hour after the 
test breakfast + J 
a glassful of water. 
When fasting + J a 
glassful of water. 
When fasting + | a 
glassful of water. 
Half an hour after 
the test breakfast 
+ J a glassful of 
water. 
One hour after the 
test breakfast 4- i 
a glassful of water. 
When fasting 4- i a 
glassful of water. 
When fasting + J a 
glassful of water. 
One hour after the 
test breakfast + | 
a glassful of water. 
One hour after the 
test breakfast 4-1 
a glassful of water. 
An hour and a half 
after the test 
breakfast 4 i a 
glassful of water. 
Do. (Further 3 min- 
utes.) 
An hour and a half 
after the test 
breakfast 4- i a 
glassful of water. 
An hour and three 
quarters after the 
test breakfast 4- i 
a glassful of water. 
An hour and a half 
after the test 
breakfast 4- 4 a 
glassful of water. 
14-2 + 7=10. 
o+o+o=o. 
I + 2 + 0=3. 
4 + l + 4=9. 
3 + 8 + 3=14. 
II + 1 + 4=16. 
16 + 0 + 0=16. 
0+2 + 0=2. 
10 + 11 + 0=21. 
5 + 0 + 0=5. 
0 + 0 + 0=0. 
4 + 2 + 0=6. 
5 + 4+2=11. 
0+0 + 0=0. 
I + 2 + l=4. 
II + 9 + 0=20. 
3 + l + 0=4. 
6 + 5 + 4=15. 
1 + 0 +3=4. 
4 + 7+0=11. 
0+0 + 0=0. 
* In the beginning of treatment there was slight stagnation of food. t Patient is much better, and there is no more stagnation of food. 
Table II (Continued).—G-ASTROGRAMS OF PATIENTS WITH STOMACH TROUBLES. 8 
THE GASTRO GRAPE. 
1. 
2. 
3 (minutes). 
Number of 
dots. 
No. 
Name. 
Disease. 
Date. 
Condition. 
1. 
3. 
5. 
7. 
9. 
11. 
13. 
15. 
17. 
19. 
21. 
23. 
25. 
27. 
29. 
XIX, 
41. 
XX, 
42. 
XXI, 
43. 
XXII, 
44. 
45. 
46. 
47. 
48. 
49. 
50. 
51. 
52. 
53. 
XXIII, 
54. 
55. 
56. 
XXIV, 
57. 
XXV, 
58. 
XXVI, 
59. 
XXVII, 
60. 
61. 
62. 
63. 
Richard L. 
Hermann K. 
Solomon C. 
Wilhelm M. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do* 
Do. 
Do. 
Do. 
William C. 
Do. 
Do. 
Sam. H. 
Arthur B. 
William W. 
Jacob F. 
Do. 
Do. 
Do. 
Gastritis gland, 
chron. 
Dilatatio ven- 
triculi; hyper- 
aciditas. 
Do. 
Anaemia ; dila- 
tatio ventriculi; 
hyperaciditas. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Do. 
Gastritis gland, 
chron.; dilatatio 
ventriculi. 
Do. 
Do. 
Anorexia; neu- 
rotic affection 
of the stomach. 
Ulcus ven- 
triculi. 
Ulcus ven- 
triculi (?) ; 
hyperaciditas. 
Dilatatio ven- 
triculi ; hyper- 
aciditas. 
Do. 
Do. 
Do. 
Mar. 28, 
1894. 
Jan. 23, 
1894. 
Jan. 2, 
1894. 
Feh. 1, 
1894. 
Feh. 11, 
1894. 
Feh. 25, 
1894. 
Mar. 3, 
1894. 
Mar. 18, 
1894. 
Mar. 19, 
1894. 
Mar. 22, 
1894. 
Mar. 26, 
1894. 
Apr. 12, 
1894. 
Apr. 12, 
1894. 
Feh. 27, 
1894. 
Feb. 27, 
1894. 
Mar. 6, 
1894. 
Mar. 10, 
1894. 
Mar. 3, 
1894. 
Mar. 19, 
1894. 
Mar. 24, 
1894. 
Mar. 28, 
1894. 
Mar. 31, 
1894. 
Apr. 7, 
1894. 
Two hours after the 
test breakfast + 4 
a glassful of water. 
Two hours after the 
test breakfast + a 
glassful of water. 
One hour after the 
test breakfast + 4 
a glassful of water. 
When fasting + a 
glassful of water. 
Half an hour after 
a glassful of water 
+ i a glassful of 
water. 
An hour and a half 
after the test 
breakfast + 4 a 
glassful of water. 
An hour and a half 
after the test 
breakfast + 4 a 
glassful of water. 
Three hours after 
the test breakfast 
+ 4 a glassful of 
water. 
One hour after the 
test breakfast + 4 
a glassful of water. 
When fasting + 4 a 
glassful of water. 
When fasting + 4 a 
glassful of water. 
An hour and a half 
after the test 
breakfast + 4 a 
glassful of water. 
Do. (Further 3 min- 
utes.) 
When fasting + a 
glassful of water. 
Do. (Further 3 min- 
utes.) 
One hour after the 
test breakfast + 4 
a glassful of water. 
Two hours after the 
test breakfast + 4 
a glassful of water. 
Two hours after the 
test breakfast + 4 
a glassful of water. 
Two hours after the 
test breakfast + 4 
a glassful of water. 
One hour after the 
test breakfast + 4 
a glassful of water. 
One hour after the 
test breakfast + 4 
a glassful of water. 
Two hours after a 
light breakfast + 4 
a glassful of water. 
When fasting + 4 a 
glassful of water. 
3 + 1 + 10=14. 
2 + 1 + 1=4. 
4 + 0 + l=5. 
1 + l+0=2. 
0 + l + 0=l. 
0 + 2 + 0=2. 
2 + 0 + 0=2. 
2 + 0 + l=3. 
8 + 0+0=8. 
7 + 5+8=20. 
0+0 + 2=2. 
0 + 0 + l=l. 
l+0+0=l. 
o+o+o=o. 
1 + 2+0=3. 
0 + 0 + 0=0. 
1 +0 +1=2. 
o+o+o=o. 
1 +0 + 0=1. 
o+o+o=o. 
5+2+0=7 
2 + 6 + 0=8. 
0 + 0 + 0=0. 
Table II (Continued).—GASTROGRAMS OF PATIENTS WITH STOMACH TROUBLES. 
Patient felt better. THE GASTROGRAPH. 
9 
conditions on different days. Some of them have been 
subjected to a very great number of tests, in order to ascer- 
tain whether there is a certain constancy in the results. 
The whole number of patients examined was twenty-seven, 
the number of tests sixty-four. 
class shows a remarkable slowness and laziness of the 
mechanical function, the number of dots being reduced 
to 4, 3, or 0. 
I might briefly state that in patient U. (xii, 15) with 
dilatation of the stomach and stenosis of the pylorus the 
number of dots was the largest. 
Table II shows the tracings we obtained in our patients 
with the gastrograph. 
In perusing the gastrograms obtained from my patients 
and comparing them with those obtained from healthy 
people, one sees that there are three different classes 
among them. One corresponds to the normal; the sec- 
ond class is marked with too much mechanical action, 
the number of dots being greatly increased; the third 
Although these investigations are as yet not finished, 
they show, however, that the gastrograph will enable us to 
widen our knowledge of the mechanical function of the 
stomach. Moreover, it will probably prove of value as a 
new diagnostic means in some pathological conditions of 
this organ. 
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