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November 30, 1957


JAMA. 1957;165(13):1696-1699. doi:10.1001/jama.1957.72980310004012

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Viral hepatitis varies in severity from a disturbance that is practically symptomless to a grave disorder marked by jaundice, prostration, and all the features of hepatic insufficiency. Treatment, therefore, cannot be uniform. There is abundant evidence, however, from studies in the armed forces and elsewhere, indicating that the average case is a self-limited affair and will run a satisfactory course irrespective of the details of clinical management. In recent years there has been a tendency to overtreat rather than undertreat this disease.

Studies of the natural course of hepatitis, acquired either through the oral or the parenteral route, indicate that there is an initial viremia with subsequent development of functional and cytological derangements of the hepatic parenchyma. The process usually leads to necrosis of the more severely affected cells. Adding to the primary disability is involvement of the cells lining the sinusoids, creating local disturbances of blood supply within the

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