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To the Editor:—
In the article of Drs. William O. Russell and William C. Stahl (The Journal, August 8, p. 1177) reporting a case of fatal poisoning from potassium thiocyanate treatment of hypertension they write repeatedly of an "accepted therapeutic dose," "the usually prescribed amount of the drug," "the standard and accepted therapeutic dose," "the usually prescribed dose," "the usually prescribed amount," "the dose of thiocyanate usually prescribed and regarded as safe." The main thesis which Barker developed and has reiterated in all his publications on this subject is that there is no usual, standard or accepted therapeutic dose. Each case is an individual dosage problem depending largely on the age of the patient, the degree of vascular sclerosis, efficiency of renal function, the increment of blood thiocyanate concentration over a short period of time and the presence or absence of congestive heart failure. In examining the protocol of this
Wald MH. COMMON ERRORS IN THIOCYANATE MANAGEMENT OF HYPERTENSION. JAMA. 1942;120(3):227. doi:10.1001/jama.1942.02830380059028