Observations on Antibiotics in the Treatment of Hepatic Coma and on Factors Contributing to Prognosis

Abstract

STRIKING advances in the diagnosis, treatment and prognosis of hepatic coma have been made in recent years. Adams and Foley¹ precisely described impending hepatic coma allowing early recognition of the clinical syndrome with the characteristic triad of flapping tremor, mental confusion and electroencephalographic changes. The importance of orally administered nitrogenous substances in the genesis of hepatic coma was emphasized by Phillips et al.² and Gabuzda, Phillips and Davidson³ in 1952, reviving a concept that had remained dormant since the early 1930's.^{4 5 6} During the next several years, many investigators confirmed the role of nitrogenous substances in hepatic coma, and further elucidated . . .