Hepatic Efficiency Tests with a Report on the Galactose Tolerance Test

Mellick, A (1931) Hepatic Efficiency Tests with a Report on the Galactose Tolerance Test. PhD thesis, University of Glasgow.

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The last quarter of a century has witnessed many advances in medicine, and not the least of these has been the application of biochemical and biophysical methods in the investigation of disease. The success which has attended these efforts, is probably best seen in the discovery of Insulin, but other advances perhaps not so epoch-making, have been made, and it is impossible at present to foretell to what heights they will lead us, or whether they will ultimately assist at all in the elucidation of the numerous problems awaiting solution. These methods have resulted in the evolution of so-called "function tests" applied to various organs of the body, and in spite of numerous theoretical objections which can be lodged against them, and they are many, there can be ho doubt that they have yielded results which have proved useful both in diagnosis and prognosis though the ultimate interpretation of these results may be a matter of dispute. In the following paper the writer is concerned with the. liver, the various tests which have been evolved for estimating whether disease be present, and if so, to what extent, and their value in the prognosis of disease. Various difficulties, which, though mainly theoretical, affect the practical value of conclusions, are met with at the outset. 1. An organ has usually many functions, while the tests applied, usually measure but one of these. 2. Deficiency in the particular function investigated does not necessarily imply deficiency in all, or even in any other function. 3. The large reserve power possessed by most organs of the body. This is well seen in the case of the liver. Up to three fourths of liver substance may be removed, without affecting appreciably the bodily economy. 4. The powers of hypertrophy and hyperplasia possessed by the liver and the ability thus to compensate for the effects of disease. 5. The particular function tested may be possessed by other organs to a varying extent, and so deficiency in an organ may be compensated by over-activity in another. 6. Each chemical process is but a part in the total metabolismof the body, and failure in one link of the chain of reactions will react on all, so that it is necessary to rule out coincident disease in other organs. Finally the question arises - what is the position when a laboratory finding is at variance with a clinical one? This can only arise from a mistaken conception as to the relative value of clinical and laboratory data. There is no essential difference between estimating the capacity of the heart for doing work and assessing the power of the kidney to excrete urea. Each item is but one link in the diagnostic chain, and must be considered in relation to the whole The task of interpretation of results is therefore very great, and caution necessary before definite conclusions can be drawn.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Keywords: Medicine, Physiology
Date of Award: 1931
Depositing User: Enlighten Team
Unique ID: glathesis:1931-79907
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 03 Mar 2020 10:23
Last Modified: 03 Mar 2020 10:23
URI: https://theses.gla.ac.uk/id/eprint/79907

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