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May 7, 1960


Author Affiliations

Western Reserve University Cleveland 6.

JAMA. 1960;173(1):87-88. doi:10.1001/jama.1960.03020190089030

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To the Editor:—  I trust Dr. G. M. Dack will allow me to criticize one portion of his excellent article, "Current Status of Therapy in Microbial Food Poisoning," published in The Journal, Feb. 27, page 929. I believe that his description of the treatment of patients with botulism leaves something to be desired. I have the feeling, perhaps unjustified, that when describing his management of secretions and failing respiration in the unhappy patients with this disease, he is writing more from the viewpoint of the general behind the lines than from the actual battle field.For example, tracheostomy is not even mentioned, and it is urgently necessary in these patients not only to clear secretions and secure a patent airway but also to protect against fatal pulmonary aspiration of stomach contents. His admonition that oral feeding should be avoided is worth heeding; in fact, one should go a step further

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