Presentation of CaseA forty-one-year-old mechanical engineer was admitted to the hospital because of hepatosplenomegaly.For the past three years he had been bleeding intermittently from hemorrhoids. Nine days before admission he entered another hospital to undergo hemorrhoidectomy; physical examination revealed enlargement of the liver and spleen, and he was transferred to this hospital.Nineteen years before entry the patient spent six weeks in another hospital because of infectious hepatitis; jaundice did not recur thereafter. He had had a duodenal ulcer that bled eight years before admission and perforated one year and again two years later, when a partial gastrectomy . . .
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Sandler et al. (1964) studied this question.