THE LACTIC ACID OF THE BLOOD IN HEPATIC DISEASE 1

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Abstract
Slight to moderate increases in lactic acid of the blood are noted in hepatic disease; particularly significant changes are noted in the more severe grades of intrahepatic jaundice and in carcinomatous obstruction to the biliary passages. These increases are comparable to those observed after experimental hepatectomy, but in general they do not exceed the renal threshold for lactic acid of 30 to 40 mgm. % in blood. Much greater elevations of values for blood lactic acid are found in some cases of clinical hepatic insufficiency, but in these cases factors other than the functional capacity of the liver are responsible for the increases noted. Disappearance of injected Na lactate from the blood of patients with hepatic disease is delayed in comparison to the rate of disappearance seen in work with normal persons. The results may be correlated roughly with those of brom-sulphophthalein or galactose tests of hepatic function. As compared with the findings in studies upon normal persons, the regulation of blood lactic acid of hepatec-tomized animals, and of patients with disease of the liver, is considerably less stable, but is not completely disorganized.