Acid Hematin (Schumm’s) Test: Detecting Free HCl in Gastric Juice
The Acid Hematin method (Schumm’s test / Salzsaures Haematin probe) qualitatively detects free hydrochloric acid (HCl) in gastric aspirate.
Principle
Free HCl converts added dimethylaminoazobenzene (pH indicator) into red rhombic crystals of acid hematin, visible microscopically.
Procedure
- Collect filtered gastric juice (fasting or post-stimulant).
- Mix equal volume with ether; centrifuge to remove lipids (upper layer).
- Add a few drops of 1% alcoholic dimethylaminoazobenzene to the clear lower layer.
- Place a drop on a slide, coverslip, and examine under high-power microscopy.
Interpretation
- Positive: Red rhombic crystals = free HCl present (normal gastric acidity).
- Negative: No crystals = achlorhydria (absent free HCl), seen in pernicious anemia, atrophic gastritis, PPI use, gastric carcinoma.
Clinical Note
Largely replaced by gastric pH measurement (nasogastric pH probe, Heidelberg capsule) and serum pepsinogen I/II ratio for parietal cell function assessment.
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