An Intravenous Galactose Tolerance Test and Its Use in Hepatobiliary Diseases1

The paper describes an intravenous galactose tolerance test performed by a single injection of 350 mg of galactose per kg body weight. Galactose in the blood was determined by a specific galactose oxidase method. The disappearance of the galactose from the blood mainly occurs by hepatic metabolism which is rate‐limited. The course of the elimination curve, however, is also influenced by extrahepatic factors. The curve was found to be most easily described as a straight line in a semilogarithmic system, the T 1/2 value for galactose being found to be 12.0 ± 2.6 min in normal adults. The galactosuria was reasonably small and constant in different clinical conditions and was therefore disregarded. The T 3/2 value was elevated in 84% of cases of liver cirrhosis, and the elevation appeared to be a good measure of the degree of liver damage. Abnormal test results were obtained in 58% of patients with acute infectious hepatitis. Among patients with an abnormal T 1/2 value more than three weeks after the onset of jaundice a long duration of the disease was generally seen, the development of cirrhosis was demonstrated in one isolated case, and one patient died. In patients with cancer metastases of the liver the test result was abnormal in 50%. The T 1/2 value was normal in 93% of cases of biliary obstruction. The galactose test was found to give valuable diagnostic and prognostic information in liver cirrhosis and in hepatitis, and also to be useful in differentiating between obstructive and parenchymatous jaundice.