Biliary atresia into the 21st century: a historical perspective.

tion. There have also been significant advances in the This commentary by the late Alex P. Mowat reflects his management of complications of chronic cholestasis extensive knowledge and experience in pediatric liver disand in some complications of cirrhosis. We have reason ease; its genesis reflects his commitment to education as well as his personal qualities. Dr. Mowat had presented an to congratulate ourselves as a profession. However, imoverview of biliary atresia at the November 1995 meeting portant as these advances are, the diagnosis of biliary of the American Association for the Study of Liver Diseases. atresia and its consequences are devastating to a famThis included a very thoughtful historical perspective. Since ily who have, for the first few weeks of their infant’s we were preparing the manuscript on Biliary Atresia, found life, believed they had a normal child. They are angry, on page 1682 of this issue of HEPATOLOGY, we informally asked to review his lecture notes and slides regarding these depressed, and frustrated when they find out that we ‘‘historical aspects.’’ Dr. Mowat died three days later while have no idea what causes the condition and very little attending a meeting in South America. Approximately one understanding of the pathogenesis and thus the progmonth after his death I was informed by his office that he nosis. It is very timely, therefore, to examine the hishad dictated these notes regarding biliary atresia; this draft was to be sent to me for commentary and possible inclusion tory of our current knowledge of biliary atresia and to with the manuscript. We are very pleased that HEPATOLOGY consider possible strategies for the future. has agreed to publish this piece, which we have lightly edited. It is an appropriate posthumous recognition of Dr. HISTORICAL DESCRIPTIONS Mowat’s many contributions to this field and perhaps a glimpse of his personal side. While much could be said The first clear reference in the English language to about the latter, I believe that the words of his fellow Scot what seems to be a case of biliary atresia is to be found Robert Burns are an appropriate tribute: ‘‘If there’s another in the writing of Professor John Burns, of the Departworld, he lives in bliss; If there is none, he made the best ment of Surgery, University of Glasgow, who in his of this.’’ —William F. Balistreri, M.D. textbook the Principals of Midwifery, Including the Diseases of Women and Children, published in 1817, wrote as follows: