Some Observations on the Diet of Jamaican Children, with Particular Reference to Liver Disease

Clinical material studied. During the past I 5 months, I 15 cases of liver disease have been investigated in this Department by Hill (1951) and Hill & Rhodes (1951). Ninety liver biopsies were performed on fifty-eight of the cases by the needle technique and, in addition, ten post-mortem specimens were examined. Though the majority of these patients looked chubby and well nourished, all had an enlarged liver (Pl. I ) and some had enlargement of the spleen with ascites and, occasionally, oedema of the legs. If ascites was present it refilled rapidly after paracentesis abdominis. None of the patients had malaria or any other acute or chronic infection or infestation with parasites. The liver sections showed a continuously developing histological picture which we have termed ‘serous hepatosis’ ; this picture, commencing with a serous exudation within the perisinusoidal spaces of Disse, passed on to the laying down of an eosinophilic coagulum which subsequently became fibrosed to give a final appearance of what is usually known as cirrhosis (Hill, 1951). Fatty metamorphosis of the liver as described by Waterlow (1948) was found only in five cases; these however showed, in addition, the fundamental pathological lesions described above. Approximately 30 yo of the total number of children, clinically and histologically, had cirrhosis of the liver with fibrosis, hyperplasia and distortion of lobular architecture ; these belonged to an older age group and had longer medical histories. Dietary investigation. The diet of each of the children suffering from liver disease was inquired into during this investigation, but the food intake of ten children was studied in more detail and compared with that of five healthy controls. Their ages varied from 9 months to 8 years, the majority being between 9 months and 3 years. Eight were male. The dietary measurements were made in the children’s homes by