DETERMINATIONS of the oxygen consumption of the liver by means of catheterization of the hepatic veins via the right side of the heart have recently shown that approximately 75% of the metabolic activity of the body at rest is contributed by the liver. This enormous activity appears all the more striking when it is realized that in a normal man the liver constitutes only about 2% of the body weight. It is not surprising, therefore, that the liver is, of all the organs, probably the most sensitive to deprivation of essential nutriments. This sensitivity reveals itself in several ways, ranging from slight impairment of functional activity to massive necrosis of the greater part of the organ with consequent rapid death of the individual. Apart from functional impairments, some of which will be discussed later in this paper, the two principal morphological changes that can be induced experimentally by dietetic means are fatty infiltration and massive necrosis. Among its many and diverse functions the liver also plays a leading part in the metabolism and detoxication of several toxic substances that from time to time may be introduced into the body either by chance or for therapeutic purposes. It also would appear probable that toxic by-products of the body's own metabolism, i.e. endogenous toxins, may also be rendered less harmful by the liver and more suitable for excretion either by the liver itself or by the other excretory mechanisms of the body. These functions, as well as others, are dependent upon the nutritional status and in consequence also upon the susceptibility of the liver to many poisons.The earliest reports on the effects of nutritional deficiency on the liver were based on studies of starvation. Total deprivation of food causes a considerable reduction in size of this organ, with loss of almost all its glycogen and a considerable part of its protein. This loss takes place so rapidly and is so readily reversible that there can be little doubt that the hepatic cells normally act as reservoirs of both carbohydrate and protein. The fat content, however, shows both a relative and absolute increase. This is largely due to the much greater part that fat plays during starvation in satisfying the caloric requirements of the body, which necessitates the mobilization of fat from the depots to the liver. The degree of fatty infiltration is therefore largely dependent upon available supplies in the fat depots in adipose tissue, and accounts for the virtual absence of fatty infiltration in emaciated subjects.' Fatty infiltration of the liver : lipotropic activityThe fat metabolism and hence the fat content of the liver is particularly susceptible to a variety of nutritional factors. The first evidence for this was the observation that pancreatectomized dogs maintained by insulin developed severe fatty infiltration of the liver that could be prevented by feeding whole pancreas or lecithin.2 A similar action on liver fat was subsequently reported by Best and Huntsman3 using rats fed on a diet rich in fat. Not only l...