Summary The study of various forms of mellituria has been neglected by the clinician for technical reasons. One-dimensional paper chromatography is a suitable new technique for extending our knowledge of this subject, as it is both sensitive and specific and can be performed in any clinical laboratory. The method we have used for the last 8 years is described in some detail. The sugar excretion in 170 twenty-four-hoururine collections of 104 full-term and premature infants has been examined and a physiologic mellituria has been observed with a moderate increase of glucose, galactose, fructose, and lactose, which lasts for the first 10 to 14 days. The pattern of the mellituria points to immature functions of the renal tubule, the liver, and the intestinal tract. There is no close time relation to the physiologic aminoaciduria of infancy. In 125 healthy children and adults, urinary excretion of sugar was minimal or absent. To obtain a general idea of the urinarysugar pattern in various diseases 1,000 selected patients were investigated, 130 of whom showed mellituria. In 114 instances the mellituria was due to the increase of a single sugar, namely to glucose in 77 cases, lactose in 13, fructose in 12, galactose in 11, and xyloketose in 1, respectively. In 16 cases the mellituria was due to an increase of more than one sugar. The diseases associated with these melliturias are discussed and some tentative figures are given as to the frequency of this association. Isolated and constant melliturias are characteristic of inborn errors of sugar metabolism while symptomatic melliturias are more variable in pattern and occurrence, though different sugar patterns can be distinguished in hepatic, renal, and intestinal disorders. The sugar excretion in the urine is affected by the sugar intake. To establish standard test conditions a sugar loading test was devised by mixing 40 Gm. glucose, 8 Gm. galactose, 30 Gm. fructose, 8 Gm. lactose, and 20 Gm. sucrose into a sugar “cocktail.” This amount was given to adults and two-thirds or one-half of it to children. Urine was collected in the fasting state and at 1, 2, and 3 hours after the sugar load. Although mild mellituria occurred after the load in every one of 45 healthy controls, the sugar increase was more pronounced in diseases of the liver, kidney, and intestine. The diagnostic possibilities of such a loading test are underlined by the fact that the fasting urine repeatedly failed to show mellituria. There was a poor correlation between the chromatographic results and Benedict's reduction test. Sugar concentrations up to 150 mg. per 100 ml. were associated with blue or blue-green Benedict reactions, and green reactions repeatedly occurred in urines free from sugar. Definite and diagnostically important melliturias such as idiopathic galactosuria may be missed if clinical investigations are limited to reduction tests, even as a screening procedure. For the accurate diagnosis of mellituria, paper chromatography is recommended as a routine procedure.