1. Gastric Ulcer. X Ray is undoubtedly superior
to test meals in usefulness.
2. Duodenal Ulcer. Usefulness of X Ray with test
meal is about equal. X Ray, of course, gives more
3. Carcinoma. Test meal is more useful in diagnosing
an early case.
4. Gastritis. The X Ray does not give any help
other than in assisting to exclude carcinoma or
ulceration, whereas the test meal is very useful,
besides aiding the Physician in the diagnosis, it
also helps him to exclude carcinoma definitely.
5. Functional Disease. The test meal gives, on
the whole, more help to the Practitioner than the
X Ray. In cases of functional disease, the X Ray
does give a certain amount of help, but it is chiefly in a negative sense, namely, in excluding organic
disease, although it does, to a certain extent assist
in the diagnosis of hypertonicity and atony. The test
meal, on the other hand, is very useful in helping the
Physician to diagnose the various conditions of the
gastric secretion, besides hypertonicity and atony of
I shall finish by stating that if the Physician,
or Surgeon, after a careful history and clinical
examination has been done, is undecided as to the
diagnosis, then a test meal should be performed. If
there is still doubt, or if more accurate information
is desired, then a radiological examination should be
carried out without delay.
Finally, both the results of X Ray examination
and the fractional test meal, unless they agree with
the history and clinical findings, should be accepted
with great caution, or ignored, or else a further examination
should be carried out,