Pathogenesis and Treatment of Hepatic Failure

Abstract

Relation of Abnormalities in Ammonia Metabolism to Hepatic Coma — Possible Importance or Other FactorsIt may be said in summary that abnormalities in the metabolism of ammonia have been established as important factors in the etiology of coma resulting from hepatic failure. The existence of other as yet undefined factors seems equally certain. It may be wise to divide coma into two groups, as suggested by McDermott²⁷: exogenous, or that resulting from the administration of protein products, or from gastrointestinal hemorrhage; and endogenous, or that occurring spontaneously, without such a clear-cut relation to an elevation in the blood . . .