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November 28, 1959


Author Affiliations

The Sansum Medical Clinic 317 W. Pueblo St. Santa Barbara, Calif.

JAMA. 1959;171(13):1866-1867. doi:10.1001/jama.1959.03010310098024

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To the Editor:—  In the Aug. 1 issue of The Journal, page 1671, a report to the Council on Foods and Nutrition, by Dr. Gerald Klatskin, entitled "Effect of Alcohol on the Liver," is presented as a review of the available evidence implicating alcohol as a factor in hepatic injury (chiefly cirrhosis). It discusses the statistical relationship between alcoholism and cirrhosis and the possible mechanisms whereby alcohol might cause cirrhosis. It concludes that chronic alcoholism is an etiological factor in the pathogenesis of Laennec's cirrhosis, but the mechanism whereby its effects are accomplished has not been clearly established.Probably the most widely accepted theory to explain the action of alcohol involves its indirect effects on nutrition, the assumption being that the malnutrition is the factor which leads to the liver damage. Dr. Klatskin includes the evidence against this idea and properly concludes that "whereas the malnutrition associated with excessive drinking

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