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The association of alcoholism and cirrhosis of the liver is widely recognized; nevertheless, it is still not clear whether the hepatic disturbance is the result of (1) an hepatotoxic effect of the alcohol or a contaminant it may contain, (2) a nutritional deficiency, or (3) a combination of the two. The concept that cirrhosis in the alcoholic may be a deficiency disease has gained popularity ever since the demonstration that fatty cirrhosis similar to that seen in man could be produced in animals by means of low protein diets (1, 2). In support of this view is the association of fatty cirrhosis with states of malnutrition unaccompanied by alcoholism (3, 4). Moreover, the apparent therapeutic efficacy of a nutritious diet, as reported by Patek and Post (5, 6), further suggests nutritional deficiency as an etiologic factor. But whether the success of this regimen resides in the diet, withdrawal of alcohol, bed rest, or in a combination of these factors, is as yet unsettled. Recently, Eckhardt and his associates (7) followed three chronic alcoholics with fatty cirrhosis maintained for eight to 13 days on a diet essentially devoid of protein but adequate in calories and supplemented with a multivitamin preparation. These patients showed striking improvement in clinical status and in hepatic function tests within a week, although histologically liver fat did not decrease significantly except in one patient during a period of choline supplementation..

COMPARATIVE EFFECTS OF A PURIFIED AND AN ADEQUATE DIET ON THE COURSE OF FATTY CIRRHOSIS IN THE ALCOHOLIC 1