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April 1936


Author Affiliations

From the Department of Surgery, the University of Chicago.

Arch Surg. 1936;32(4):624-668. doi:10.1001/archsurg.1936.01180220050004

Acholic cachexia, or cachexia cholipriva, is a condition of rapid emaciation terminating fatally which results from complete external drainage of bile. It is indeed astonishing that the prompt fatal outcome of this condition has been recognized only in recent years. Wangensteen's1 recent review of the older literature revealed a truly astonishing series of statements made by many of the foremost scholars of the last two generations and continuing up to the early 1920's. Such able clinicians as Moynihan,2 Murphy,3 Courvoisier,4 Robson,5 Deaver6 and Balfour and Ross7 published comments on the apparent innocuousness of complete loss of bile. All believed it was harmless, although Balfour commented on anemia which usually appeared. Bernays,8 on clinical evidence, stated that "bile is almost if not entirely as much of a secretion as urine."

However, since the decisive series of studies by Whipple and his co-workers, the

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