To the Editor:
—My contention (Arch. Int. Med. 52:147 [July] 1933) that the modified dextrose tolerance test is not a satisfactory measure of the metabolic function of the liver was based on results obtained by performing this test on ten patients who were considered to have normal livers and on four patients with frank hepatic disease. In nine of the ten normal patients, definite chemical and clinical hypoglycemia developed—the response said by Dr. Althausen to be characteristic of disease of the liver. Three of four of the patients with hepatic disease also exhibited a terminal drop in blood sugar which was somewhat, but not markedly, lower than in most of the normal cases. There was, therefore, no essential difference between the behavior of the normal and the abnormal groups.The important criticisms of this work which are raised in Dr. Althausen's present communication revolve about two questions: 1. Were the patients normal? 2.