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March 9, 1929

Nouveau traité de médecine.

JAMA. 1929;92(10):833. doi:10.1001/jama.1929.02700360071034

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In this number, a satisfactory chapter on the physical and functional examination of the liver is followed by an almost classic study of the hepatic syndromes: insufficiency and overaction, portal hypertension and icterus. Among the diseases of the liver, hepatic cirrhosis is dealt with at particular length. In its etiology, alcoholism is given first place, but merely as a predisposing cause which lessens the resistance of the hepatic parenchyma and thereby favors localization in it of chronic infection, the liver cells presenting as they do the first obstacle to systemic invasion from the alimentary tract and also serving in defense against other infections, particularly syphilis. In view of the importance of early diagnosis, while it is still curable—especially if syphilitic by means of mercury, bismuth and iodide—certain urinary tests, elaborated chiefly by the French, capable of revealing the preascitic stage of cirrhosis, should be more generally known in this country.

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