THIS INVESTIGATION was carried out to determine the practicability of routine urine bilirubin determinations employing a simple chemical test. Routine tests are justified only when the results obtained are sufficient to make the effort expended worth while. Konzelmann1recommended routine testing for bile pigment in the urine using the Harrison spot test in 1948, because it yielded helpful information in a wide variety of symptom complexes. Shutkin and Caine2reported the results of testing for bile in the urine of 1,000 consecutive hospital admissions in 1954. They used a diagnostic reagent (Ictotest) for determining bile in the urine and found unsuspected liver disease in 1%. They recommended that this test be routine. Material and Methods The results reported in this paper were recorded during the course of routine examination of the urines from patients attending The Elkhart Clinic, Elkhart, Ind., in the 6-year period from 1954 through 1959.