Augmented histamine test,ewald test meal,and diagnex test

Summary and conclusions The augmented histamine test, the Ewald test meal, and the Diagnex tests have been compared in a series of 130 patients. The results indicate that although the results of these tests follow the same trend in a group of patients, no one test can be used to predict satisfactorily the results of the other two tests in the majority of individual patients.Although the Ewald test is as informative as the augmented histamine test in supporting a clinical diagnosis of duodenal ulcer, the latter shows most clearly the wide variations in the degree of hypersecretion in different patients with duodenal ulcer and is the most reliable test for establishing the presence of achlorhydria. The augmented histamine test is virtually free of any serious side effects and, furthermore, provides a reliable index of the parietal-cell mass. The augmented histamine test would thus appear to be of particular value as a guide to the nature and extent of surgery necessary for the satisfactory reduction of acid secretion in patients with peptic ulcer.Our findings support the claims made by previous workers regarding the value of the Diagnex test in the screening of large numbers of patients for achlorhydria or marked hypochlorhydria. Apart from its usefulness as an initial screening test in cancer detection programs, the test has a limited place in excluding a diagnosis of pericious anemia or duodenal ulcer.We wish to record our deep obligation to E. R. Squibb and Sons, New York, for supplies of Diagnex Blue and Diagnex reagent, and to Merck Sharp and Dohme, West Point, Pa. for supplies of Neo-Antergan maleate.