Abstract
The evidence available at the present time suggests that alcohol may induce a relative deficiency of choline leading to fatty infiltration and fibrosis of the liver by (1) limiting food consumption, (2) increasing the choline requirement, and (3) possibly by augmenting the caloric intake. In addition alcohol may raise the level of fat in the liver by stimulating fat synthesis and by mobilizing fat from the depots. Whether these latter actions are responsible for the apparent increase in the choline requirement induced by alcohol and whether they play a significant role in the development of cirrhosis is still uncertain. Although these nutritional and metabolic effects of alcohol appear to be important the possibility must be considered that other environmental or constitutional factors are involved in the pathogenesis of Laennec's cirrhosis in the chronic alcoholic.