302 ISIDOR GREENWALD 



always able to demonstrate the presence of the enzyme in the feces. Ap- 

 parently, we are here concerned with an abnormal permeability of the 

 gastro-intestinal mucosa, which permits the absorption of lactose, before 

 it has been split into glucose and galactose. The liver and other organs 

 can effectively handle these sugars only, not their combination, lactose. 



The same explanation will probably apply to the results of von 

 Halasz, who observed that in twenty-two out of twenty-three cases of carci- 

 noma or dilatation of the stomach, the ingestion of 150 grams of lactose 

 was followed by the appearance of lactose in the urine, whereas in forty- 

 five other individuals with a variety of pathological conditions, including 

 eight with cirrhosis of the liver, two with echinococcus cysts of the liver 

 and four with carcinoma of the esophagus, liver or gall-bladder, this result 

 was not obtained. 



Bauer found that the ability of the organism to utilize 30 or 40 

 grams of ingested galactose was seriously depressed in certain hepatic 

 disorders. The excretion of traces of the sugar in the urine had no 

 particular significance, slightly larger amounts were found in various 

 hepatic conditions in which the parenchyma might be considered to be 

 affected, and more than four grams in the urine was indicative of catarrhal 

 icterus, acute yellow atrophy, phosphorus poisoning, etc. Other workers 

 (Rountree, Hurwitz and Bloomfield, Worner and Reiss) have, in general, 

 confirmed Bauer's results, although there have also been reports of the 

 occurrence of alimentary galactosuria in nephritis and in Basedow's 

 disease (Maliwa). As in the case of alimentary fructosuria, this 

 may be due to a coexisting hepatic dysfunction, though other evidence 

 thereof is lacking. 



Recognition. Lactose and galactose are both dextrorotatory, [a] 2 ^ -f- 

 55.16 and + 81, respectively, and both reduce alkaline copper and 

 alkaline picrate solutions. Galactose is fermented by yeast, though more 

 slowly than glucose. Lactose itself is not fermented but, as the test is 

 ordinarily performed, it may be split into glucose and galactose by some 

 contaminating organism and the simple sugars then fermented by the 

 yeast. Positive proof of the presence of galactose, free or combined, is 

 best obtained with the mucic acid test. To the urine or the filtrate from 

 precipitation with mercuric nitrate, add one-tenth volume of concentrated 

 nitric acid (sp. gr. 1.42) and evaporate on the water bath to a little more 

 than the volume of the nitric acid added. After standing twenty-four 

 hours, add one-half volume of water and allow to stand another twenty-four 

 hours. 



Mucic acid crystallizes out in minute, rhombic prisms, which melt 

 at 212-215. The crystals obtained may be purified by filtering, washing 

 with a little water, dissolving in dilute ammonium hydroxid, filtering, 

 evaporating to dryness and adding 5 c.c. dilute nitric acid (sp.gr. 1.15). 

 The crystals may now be filtered, washed with a little water, alcohol and 



