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July 31, 1967

Toxicity of Indomethacin

JAMA. 1967;201(5):333-334. doi:10.1001/jama.1967.03130050067036

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To the Editor:—  The article "Toxicity of Indomethacin" (200:552, 1967) deserves comment and critical objections.First, there is not the slightest proof in the reported case that the attack of acute pancreatitis was due to the indomethacin which the patient had been taking without ill effects for more than three months. Post hoc is not necessarily propter hoc. In the comment the author writes, "We ruled out biliary disease [as etiologic factor] because of a normal gallbladder series." This, however, is not mentioned in the report of the case, just as the gastrointestinal series taken two weeks after the onset is mentioned only in the comment.The author, moreover, does not seem to realize that a normal biliary tract, by x-ray or by inspection, (as published by me and others years ago) does not rule out a common channel between common bile duct and pancreatic duct, this common channel