Abstract. On the basis of the literature and personal analysis of symptoms and signs in 25 gastrectomized patients, new criteria for the dumping syndrome have been outlined. The clinical diagnosis of the dumping syndrome was based upon a clinical diagnostic index. The method was then applied to 49 partially gastrectomized patients. It is stressed that three of the cardinal symptoms may easily be overlooked, viz. sleepiness, dizziness, and restlessness. Eructation and vomiting are components of the afferent loop syndrome and the small stomach syndrome. After a test meal of hypertonic glucose the percentage changes in plasma volume were measured by Evans blue, hematocrit, and hemoglobin values. All three methods revealed statistically significant differences between dumpers and non‐dumpers as regards the mean values of the percentage fall in plasma volume. An increasing fall in plasma volume was generally parallelled by a rising clinical diagnostic index. All patients who showed a fall in plasma volume above 15% were dumpers. Women showed a greater fall in plasma volume and a distinctly larger clinical diagnostic index than men. Statistically significant differences were found between dumpers and non‐dumpers as regards the rise in blood sugar after the test meal.

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Abstract. Five related cases of primary lymphoedema combined with recurrent cholestasis are reported. The cholestasis was of intrahepatic origin with defective excretion of conjugated bilirubin, bile salts and lipids. During the cholestasis malabsorption was demonstrated and the patients were jaundiced and complained of severe itching. From prepuberty the patients developed massive oedema in the legs, enamel defects and discoloration of the teeth. Severe pathology was demonstrated by lymphangiography in the lower extremities in three of the patients. In the non‐icteric periods the biochemical parameters were normal, but the peripheral oedema persisted. Liver histology showed only slight degeneration of some of the parenchymal cells, but no progressive fibrosis. Hepatic radionuclide lymphography with colloidal 198Au was performed in one patient. No lymphatic drainage was found suggestive of changes of the lymphatics in the liver. It is proposed that disturbed lymph flow of the liver is the main aetiological factor in the production of the recurrent intrahepatic cholestasis.