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April 7, 1945


JAMA. 1945;127(14):945. doi:10.1001/jama.1945.02860140062021

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To the Editor:—  I wish to comment on the article of Holter and Horwitz on "Spontaneous Pneumothorax Produced by Ascent in an Airplane" (The Journal, March 3, p. 519). They state that the intrapleural pressure in the potential space falls from 756 mm. of mercury to 560 mm. of mercury by ascent from the ground to an altitude of 8,000 feet, "thereby creating a tendency for the lung to collapse partially." I believe that the latter statement is untrue, for actually the only factor tending to separate the visceral and parietal pleurae is the elastic pull of the lung tissue. At any altitude and all altitudes, with the visceral and parietal pleurae in apposition and the pleural space merely a potential one, atmospheric pressure exerts an equal push on the inside of the visceral pleura and the outside of the parietal pleura. At any elevation it is only the elastic

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