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August 13, 1973

Magnesium Toxicity

Author Affiliations

St. Luke's-Memorial Hospital Center Utica, NY

JAMA. 1973;225(7):751. doi:10.1001/jama.1973.03220340055035

To the Editor.—  In their article "Magnesium Sulfate Enema in a Newborn" (224:1392, 1973), Outerbridge et al demonstrate the toxicity of this metal. In doing so, however, they appear to confuse the misuse of medication with its effects when used in therapeutic quantities, and they further condemn the physiologic rationale on which the treatment was based. Specifically, they note that the infant they describe received 100 ml of a 50% solution of magnesium sulfate by enema, whereas in the initial publication on this subject (Am J Clin Pathol 44:259, 1965) the amount recommended was 15 ml. This is almost a sevenfold overdosage. It may be pure coincidence, but the 100-ml dose is precisely that which was used in a study that purported to show the toxic reactions of magnesium sulfate in newborn lambs, animals markedly smaller than newborn infants (Lancet 2:64,1965). Overdosage of this magnitude of any substance, even water,