Much study of the liver has shown that it has so large a factor of safety that even when quite severely injured by disease it is still capable of performing its metabolic functions adequately. These studies have nearly all been made from the point of view of excretion, however, and but little work has been done on the speed of absorption and the utilization of foods in liver disease. With the disturbances of circulation found in cirrhosis, and the marked loss of liver tissue, it seems reasonable that, at least, the speed of utilization of foodstuffs might be delayed. This can best be studied by the respiratory metabolism, and in this paper, therefore, the question of total metabolism and of utilization of protein in liver disease is discussed.
The specific dynamic action of protein is a term first given by Rubner1 to the increase in total heat production which follows