acid,  while  the  material  obtained  after  a  test-breakfast  presents
little  signs  of  digestion,  and  the  filtrate  is  found  to  possess  an
abnormally  low  acidity  with  an  absence  of  the  free  mineral
acid.  Lactic  acid  is  often  present.  In  the  early  morning,
after  lavage  on  the  previous  night,  only  a  little  opalescent
fluid  devoid  of  free  hydrochloric  acid  can  be  withdrawn  by
the  tube.  When  a  simple  ulcer  has  become  the  seat  of  a
cancerous  growth  the  antecedent  hypersecretion  sometimes
persists  for  a  few  months.
Simple  chronic  gastritis  does  not  present  the  two  symptoms
that  are  characteristic  of  hypersecretion,  namely,  the  painful
crises  and  the  vomiting  of  large  quantities  of  acid  gastric  juice.
On  the  other  hand,  the  subjects  of  this  complaint  suffer  from
distention  and  flatulence  within  one  hour  after  each  meal,
and  when  they  vomit  the  ejecta  consists  of  undigested  food
mixed  with  much  mucus  but  deficient  in  hydrochloric  acid.
Appendicular  hypersecretion  with  subacidity  may  be  indis-
tinguishable from  simple  chronic  gastritis.
Biliary  colic  and  enterospasm  may  be  mistaken  for  h)rper-
secretion  if  attention  is  concentrated  upon  the  abdominal  pain ;
but  the  general  history  of  the  case  combined  with  an  examina-
tion of  the  abdomen  will  soon  clear  up  any  difficulty  of
diagnosis.
Hypersecretion  has  more  than  once  been  mistaken  for
diabetes  owing  to  the  coexistence  of  emaciation,  thirst,  and
hunger.  In  ordinary  diabetes,  however,  pain  during  digestion
and  vomiting  are  never  encountered,  while  the  special  indica-
tions of  the  secretory  disorder  are  absent;  but  it  must  be
remembered  that  chronic  pancreatitis  sometimes  complicates
duodenal  ulcer  and  in  this  condition  glycosuria  may  become
associated  with  hypersecretion.
