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April 23, 1938


Author Affiliations

San Francisco.

JAMA. 1938;110(17):1386. doi:10.1001/jama.1938.02790170066024

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To the Editor:—  I have read with interest the report of Helwig, Schutz and Kuhn in The Journal of February 26. Since they refer to some of our experimental studies (Smyth, F. S.; Deamer, W. C., and Phatak, N. M.: Studies in So-Called Water Intoxication, J. Clin. Investigation12:55 [Jan.] 1933), I feel justified in voicing an opinion regarding their interpretation. In the acute water intoxication induced experimentally by us in dogs, vomiting, not diuresis, was the more characteristic result. Water was given by gavage; no parenteral fluids were administered. In such cases the course was brief, the electrolyte loss was largely gastric hydrochloric acid, the result a relative alkalosis from acid deficit.In contrast with these observations, the clinical picture described by Helwig and his co-workers is much more confused. The prolonged course with possible starvation, anesthesia, ketosis (or infection?) added potential acid fractions. No determinations of total

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