June 13, 1966

A Comedy of Errors

Author Affiliations

Kansas City, Kan

JAMA. 1966;196(11):1026. doi:10.1001/jama.1966.03100240159052

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To the Editor:—  In one of their statements about constitutional reactions being followed by a period of refractoriness, the authors refer to Vaughan's text of 1939, which like every other textbook of allergy assumes the efficacy of hyposensitization. The authors have concluded that "it is known" that injections below the constitutional reaction level also confer refractoriness.Their patient follow-up seems to have depended on evaluation by a lay study clerk. Great reliance was placed on symptoms reported by parents and on the number of antihistamine tablets they gave their children.Questions pertaining to accuracy of the symptom cards were referred to the physicians in the clinic who further questioned both child and parent.Nothing is said about physical examination or laboratory procedures. Observations on asthma had to be discarded the first year because patients did not understand that "difficulty in breathing" was supposed to mean asthma. There is no question

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