652 LOUIS BAUMAN 



ing disorders: Phosphorus poisoning, alcoholism, chloroform poisoning, 

 parenchymatous degeneration of the liver, jaundice and cirrhosis. 



Certain observers failed to confirm the value of the test (Shirokauer 

 (&) ; Chesney, Marshall and Rowntree; Bloomfield and Hurwitz). 



Bauer (d), who first suggested galactose, found a diminished tolerance 

 for this sugar in all cases of catarrhal jaundice. Draudt obtained a 

 positive galactose test in Eck fistula dogs and Roubitschek in dogs poisoned 

 with phosphorus. Wagner confirmed Bauer's results in catarrhal 

 jaundice. 



Summarizing, one may say that while the results of the carbohydrate 

 tolerance tests are to be cautiously interpreted, nevertheless a positive out- 

 come has a certain confirmatory value. As previously stated, blood sugar 

 determinations following the administration of these sugars will bring 

 forth additional information which may enhance the value of these tests. 



The administration of amino acids to patients suffering from liver 

 disease is followed by an increased excretion of amino nitrogen in the 

 urine (Jastrowitz; Masuda; Glaessner; Falk and Saxl). Frey observed 

 an increase in amino acid excretion in cirrhosis and in animals poisoned 

 with phosphorus or in whom the common bile duct had been tied, but found 

 no change in the urea or ammonia excretion. The absence of fibrinogen in 

 the serum has been observed in diseases of the liver and in animals poi- 

 soned with phosphorus and chloroform (Marshall and Rowntree; Whip- 

 pie). The lack of fibrinogen may prevent coagulation of the blood (Doyou 

 and pupils). Goodpasture noted autodigestion of the blood clot in 4 cases 

 of cirrhosis confirmed by autopsy. 



Whipple(a) noted an increase in the blood lipase in various liver 

 diseases. 



The rate of excretion of phenoltetrachlorphthalein in experimental 

 lesions of the liver was determined by Whipple, Mason and Peightal, who 

 emphasize the reliability of the test. Rowntree and assistants found that 

 the dye was excreted in diminished amount in cirrhosis, carcinoma and in 

 extreme congestion of the liver. 



Marshall and Rowntre record the following observations on dogs 

 poisoned with phosphorus and chloroform. An increase in blood lipase, a 

 decrease in fibrinogen and a decrease in phthalein excretion. In phos- 

 phorus poisoning an increase of non-protein nitrogen, urea and amino- 

 nitrogen in the blood. In chloroform poisoning the tolerance for levulose 

 and galactose was decreased. An increased excretion of amino-nitrogen 

 was observed in both conditions. 



Jaundice. The presence of bile in the blood and tissues and its absence 

 from the intestine produces the condition called jaundice. 



In incipient or slight jaundice bilirubin may be present in the blood 

 serum before it appears in the urine or before it has stained the skin and 

 mucous membranes. It is probable that bilirubin is combined with the 



