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William Francis Rienhoff Jr., M.D.; Alan C. Woods Jr., M.D.
JAMA. 1953;152(8):687-690. doi:10.1001/jama.1953.03690080031009.
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The surgical treatment of disturbances of the blood flow through the liver resulting from intrahepatic disease and caused, in the majority of patients, by one of the various types of cirrhosis of the liver, has been and continues to be unsatisfactory in many patients. There is no question that, at present, medical management in cases of cirrhosis of the liver is the treatment of choice. In spite of commendable adherence by a patient to any particular medical regimen, however, such treatment is too often ineffectual, and the patient succumbs to progressive liver failure, in addition to wasting ascites and/or exsanguination, with one or more repeated bouts of bleeding from esophageal varices. The inability to judge clinically and by liver function tests the degree of irreversible damage in the parenchyma of the liver and, thus, the extent of the departure from normal and the reduction of liver function often makes it


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