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AMA Arch Intern Med. 1954;94(5):785-800. doi:10.1001/archinte.1954.00250050099010.
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CLINICAL, functional, and structural alteration of the liver due to disturbances of nutrition have attracted increasing interest for many unrelated reasons. Changes were seen in frank starvation in concentration or prisoner-of-war camps,* in undernutrition, in disease, and in malnutrition resulting from poorly balanced therapeutic diets. Moreover, the role of malnutrition in the hepatic alterations of tropical disorders and alcoholism has been appreciated. Basically, three mechanisms produce nutritional injury: (a) undernutrition or starvation, (b) specific deficiency of one dietary constituent, and (c) imbalanced nutrition (malnutrition). The total caloric intake is not necessarily altered in the last two. From the practical point of view, at least in this country, undernutrition and specific deficiency are far less important than malnutrition. Clinical observations concerning nutritional hepatic injury are difficult to evaluate, because of the unreliability of the nutritional history and because of the frequent coincidence of other factors, especially infections. The study of the


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