To the Editor.—I was delighted to receive Dr. Becroft's communication regarding acute encephalopathy and fatty change of the viscera. His report deserves the attention of all physicians interested in this problem.
The possible epidemiologic nature of some cases is of importance and has also been called to our attention by reports from Czechoslovakia and North Carolina.1,2
We must continue to study our cases carefully by chemical analysis for possible toxins, and for viral agents. Recent comments by Mortimer3 calls attention to an apparent relationship between salicylates and hypoglycemia in clinical, and experimental situations. Unfortunately, details of salicylate administration and verification by salicylate levels are not always available in the literature.
I would think it not profitable to debate degrees of hepatic fatty metamorphosis. We know that the liver cell responds to many diverse agents of injury by exhibiting cytoplasmic accumulation of lipid. Under the electron microscope, these