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SUMMARY Studies of basal and histamine-stimulated gastric acid secretion were performed in 42 controls, in 133 patients with duodenal ulceration, in 57 patients with gastric ulceration, in 13 patients with both duodenal and gastric ulceration, and in 20 patients with gastric carcinoma. All these subjects were Chinese. Statistical analysis of the results showed that all clinical groups differed from the controls in both basal and stimulated secretion. The mean basal acid output of Chinese controls and of patients with duodenal ulcer in most cases did not differ statistically when compared with western series. The basal secretion of Chinese patients with gastric ulceration, however, was statistically higher than in most of the western series. The histamine-stimulated response of Chinese controls and patients with duodenal ulcer was statistically much lower than in all western series with which they were compared. For Chinese patients with gastric ulcer, the stimulated responses were in some instances lower than and in others similar to results obtained in some western series. In contrast to most western reports, the basal and histamine-stimulated secretion in Chinese patients with gastric ulcer was significantly higher than in controls. In the Chinese controls and Chinese patients with peptic ulcers the response after histamine was generally lower than western reports. This was due to the inadequacy of the standard dose of histamine acid phosphate of 0.04 mg/kg body weight in Chinese subjects. A dose of 0-06 mg/kg body weight produced a significantly higher acid output. In the comparatively leaner Chinese subjects, therefore, a dose of histamine acid phosphate of 0.06 mg/kg is required for maximal stimulation of gastric acid secretion. This agrees well with the results of a similar study in Indian subjects.

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The effect of smoking on gastric acid secretion was studied in 16 smokers and 16 non-smokers. The basal, smoking, and peak acid outputs were determined. Statistical analysis showed the following results : No significant difference was found between the mean basal acid output and mean smoking acid output, in both smokers and nonsmokers. The mean peak acid output was significantly much higher than both the mean basal and smoking acid outputs, in smokers and non-smokers. There was no significant difference in the mean basal, smoking, and peak acid outputs between smokers and non-smokers. When the difference between basal and smoking acid outputs were considered in each individual case, however, the smoking acid output tended to be lower than basal in smokers, but higher than basal in non-smokers. This difference was just significant. It is concluded that while smoking has no significant effect on gastric acid secretion in smokers and non-smokers, there appears to be a significant difference in the gastric secretory response to smoking between smokers and non-smokers.The earliest investigations into the effect of smoking on gastric secretion were made by Wolffl (1889) and Skaller2 (1909). Since then, studies of the effect of smoking on gastric secretion have given conflicting results. Some workers have found that smoking depresses or has no effect on gastric ~e c r e t i o n~-~, while others have found that smoking stimulates gastric secretion6-12. Recently, more sophisticated studies have been performed by Debas at all3 and Wilkinson et all4. Again, conflicting results were obtained since no significant change was found in and significant inhibition was found in the other14. The present study attempts to determine the effect of smoking on the gastric acid secretion of 32 subjects, and to compare the results with the basal and pentagastrin-stimulated peak acid outputs. Method