Simultaneous Cholecystography and Determination of Liver Function.

Since the introduction of cholecystography by us three years ago, we have instituted many changes and modifications to enhance its value. A short time ago we substituted phenoltetraiodophthalein for tetraiodophenolphthalein for several reasons. A smaller dose is required, the time of filling and emptying of the gallbladder is shortened, and the blood serum is stained so that readings on the excretion by the liver can be obtained.

The dose of phenoltetraiodophthalein is 0.04 grams per kilo of body weight, and is preferably given in the morning intravenously on an empty stomach. The dose need not exceed 2.5 grams. Lunch should be omitted, but if hunger demands, the diet should be limited to liquids without fats and low in proteins. Water is allowed. Roentgenograms are taken 4, 8 and 24 hours after the injection.

The solution is prepared by dissolving 2.5 grams phenoltetraiodophthalein in 30 or more cc. freshly distilled water, filtered and sterilized in a water bath for 15 or 20 minutes. A specimen of blood is taken before giving the dye and one-half hour afterwards. The blood is allowed to clot, preferably in an icebox and centrifuged. The serum is removed, alkalinized and compared with standards in a manner similar to the Rosenthal modification 1 of the phenoltetrachlorphthalein test for liver function.

The standards are prepared by dissolving 48 milligrams phenoltetraiodophthalein in 100 cc. distilled water. This is used as the 100 per cent solution, and 10 or 12 dilutions are made between 100 per cent and 5 per cent. A small amount of alkali must be added to the standards to keep them from fading.