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Article
October 1954

ACUTE HEPATIC INSUFFICIENCY OF THE CHRONIC ALCOHOLIC: Clinical and Pathological Study

Author Affiliations

BOSTON

From the Thorndike Memorial Laboratory, Second and Fourth Medical Services (Harvard), Boston City Hospital, and the Department of Medicine, Harvard Medical School and the National Institute of Arthritis and Metabolic Diseases of the National Institutes of Health, Bethesda, Md. Research associate in medicine, Harvard Medical School; research fellow, Thorndike Memorial Laboratory; senior assistant surgeon, National Institute of Arthritis and Metabolic Diseases (Dr. Phillips) and associate professor of medicine, Harvard Medical School; associate physician, Thorndike Memorial Laboratory; associate director, Second and Fourth Medical Services (Harvard), Boston City Hospital; formerly chief of clinical research, National Institute of Arthritis and Metabolic Diseases (Dr. Davidson).

AMA Arch Intern Med. 1954;94(4):585-603. doi:10.1001/archinte.1954.00250040077007
Abstract

MOST CHRONIC alcoholics with active but uncomplicated cirrhosis demonstrate rapid improvement in their liver disease, in our experience, following hospitalization and consumption of an adequate diet. At times, however, acute severe hepatic functional impairment occurs, which may clear slowly or progress until the patient dies in hepatic coma. In this situation, the liver may show, in addition to fat and fibrosis, an extensive lesion characterized by hyaline degeneration and necrosis of parenchymal cells with leucocytic infiltration. This lesion, which was described by Mallory in 1911 1 and which occurs in varying degrees of severity in many alcoholics, is so distinctive that it was decided to determine further its clinical significance. To do this, the present study was carried out, in which the clinical and pathological findings relating to the liver in 56 chronic alcoholics were analyzed. It was found possible to divide these cases, according to histological findings, into two

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