S experiments of a century ago stimulated interest in the relation between functions of the brain and glucose metabolism. Some authors, including Jelliffe,1 have since reported metabolic abnormalities in multiple sclerosis; the reported changes consisted in a low fasting serum inorganic phosphorus 3 and a high fasting serum cholesterol.2 More recent studies in patients with multiple sclerosis revealed elevation of the fasting blood pyruvic acid concentrations and an excessive accumulation of this substance following the ingestion of glucose; decreased glucose tolerance and abnormally great and prolonged fall in serum inorganic phosphate were also observed.4 These workers confirmed earlier reports of a low fasting serum inorganic phosphorus and a high fasting serum cholesterol.The experiments reported here were designed to elucidate further the nature of metabolic defect already reported to occur in multiple sclerosis. Our studies did not confirm the finding of elevated fasting pyruvic acid concentrations reported by other investigators; however, decreased glucose tolerance was observed, and additional abnormalities in lactic and citric acid metabolism were found.
MATERIALS AND METHODSSix patients with active multiple sclerosis, ranging in age from 38 to 56, were studied; four of the subjects were men (Appendix). All were free of malnutrition, fever, increased intracranial pressure, and intercurrent disease. All were cooperative during the test. All had a 350 gm. carbohydrate intake daily for three to five days prior to the test. Twenty normal subjects of comparable age served as controls. One subject with a past history of multiple sclerosis but with no present detectable signs or symptoms of the disease was also studied (Case 8).Blood samples were taken after a 12to 13-hour fast, and again 1, 2, and 3 hours after the ingestion of 100 gm. of glucose dissolved in 200 cc. of distilled water. Venous stasis and controllable muscular activity were avoided. No anticoagulants were used except for blood glu¬ cose and plasma citrate ; the red cells were lysed and the proteins precipitated immediately upon collection; the filtrates were kept iced. Determinations were made within four hours after Postdoctorate