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December 1959

Newer Concepts of Cirrhosis

Author Affiliations

New Haven, Conn.

Professor of Medicine, Yale University School of Medicine.

AMA Arch Intern Med. 1959;104(6):899-902. doi:10.1001/archinte.1959.00270120055008

The key to progress in our understanding of cirrhosis has been the recognition that the cirrhotic process represents the end-stage of a wide variety of pathological processes of diverse etiology. Accordingly, the term cirrhosis no longer implies a specific clinical or pathological entity but now encompasses a group of diseases that differ not only in etiology and pathogenesis but also in clinical behavior and therapeutic requirements. To review recent developments in our concept of cirrhosis, the topic I have been assigned, would take us into such diverse areas as the morphology of the hepatic changes induced by malnutrition, alcohol, toxins, and infections; the epidemiology, identification, and immunology of viral hepatitis; the biochemistry and histology of collagen formation; the genetics and biological effects of disturbances in the metabolism of galactose, iron, and copper, and many others. Obviously neither time nor my own limitations would permit a comprehensive review of this subject.