Acute liver failure

To the Editor: William M. Lee's masterly review of acute liver failure indicts trichloroethylene as a direct liver toxin (Dec. 16 issue)¹. This allegation is inconsistent with the fact that trichloroethylene was used for years as an anesthetic and was administered to hundreds of thousands of men, women (including pregnant women), and children, without untoward effects. During the period of this use, trichloroethylene was not thought to cause hepatic injury. The activity of trichloroethylene is quite unlike that of carbon tetrachloride, which predictably produces dose-related hepatic injury. Lee provides two citations to support his assertion that trichloroethylene and tetrachloroethane.