SOME ASPECTS OF CARBOHYDRATE METABOLISM IN HEPATIC DISEASE

The intravenous injection of dextrose as a preoperative and postoperative measure in poor surgical risks presenting lesions of the biliary apparatus is now so universal that it would seem worth while to consider what we are attempting to do when we administer carbohydrates in these cases. What evidence is there that indicates the existence of a perversion or deficiency of carbohydrate metabolism? In many clinics the administration of dextrose is merely a routine procedure and little thought is given to the object to be attained by its use. Well known physiologic facts concerning the rate of utilization, the effect of dehydration on the ability of the liver to store glycogen, and whether or not insulin should be used in conjunction with dextrose are not given the thought which they require if satisfactory therapeutic effects are to be obtained. At the present time data are not available as to whether or