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October 20, 1962


JAMA. 1962;182(3):293-294. doi:10.1001/jama.1962.03050420069020

One of the widely accepted theories of the pathogenesis of "Laennec's" cirrhosis has been put to a severe test and found deficient, according to recent investigations by Richard A. MacDonald.1 Reporting his findings in the current issue of the Archives of Internal Medicine, MacDonald states: "The concept that in the formation of cirrhosis focal or nodular regeneration is the critical factor after parenchymal cell injury, leading to formation of fibrous bands, should be discarded." The conclusions are based primarily on a study of rats fed a low-protein, high-fat, choline-deficient diet and given H3-thymidine for detection of synthesis of deoxyribonucleic acid. Observations were also made on the livers of rats with experimentally induced cancer and biliary obstruction, and on approximately 1,000 cases of human cirrhosis.

The process suggested by his study involves injury to liver cells, followed by cellular swelling and obstruction of the flow of lymph and