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December 3, 1982

Cirrhosis of the Liver and Mallory's Bodies Without Alcoholism

JAMA. 1982;248(21):2837. doi:10.1001/jama.1982.03330210029026

To the Editor.—  The recent article on humility (1982;247:3193) brought to mind an experience I had several years ago. A well-liked physician on our staff was admitted for evaluation of hepatomegaly. The liver biopsy specimen disclosed cirrhosis and Mallory's bodies. We knew this physician socially and could attest to his abstinence from alcoholic beverages. The result of the grand rounds on his case was the impression that Mallory's bodies might not be pathognomonic for alcoholic liver disease. Support for that assessment can be found in an article by Roche-Sicot and Benhamou,1 which described a 13-year-old patient with Wilson's disease. Much of my internship was devoted to gaining a perspective for validated information. Much of medicine is, perhaps, predicated on assumptions. As an intern, I was often challenged by my attending physicians to identify the published data on which a "standard textbook" statement was based. It was not uncommon to