Active hepatic insufficiency of the alcoholic, when severe, is often fatal.1,2 The cause is unknown, and treatment with alcohol withdrawal and a nutritious diet has doubtful specificity. The disease is characterized histologically by liver-cell necrosis, "alcoholic hyalin" (Mallory),3 polymorphonuclear infiltration, and parenchymal disorganization. Hepatic fat is usually present in large amounts, but the necrotic lesion appears to be independent of the amount of fat. Outstanding clinical features are jaundice (sometimes simulating extrahepatic obstruction),4,5 polymorphonuclear leukocytosis, as well as other evidences of severe liver disease.
This report concerns a patient with histologic and clinical abnormalities as marked as we have seen, yet recovery occurred with restitution of almost normal liver function and histology.
A 49-year-old male was admitted to the II and IV (Harvard) Medical Services, Boston City Hospital, after about 2 months of progressive fatigue, weakness, and anorexia. A week earlier he had observed light stools, dark