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December 29, 1945


JAMA. 1945;129(18):1286. doi:10.1001/jama.1945.02860520054019

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To the Editor:—  I should like to comment on your answer to an inquiry regarding the usefulness of injections of distilled water (The Journal, Oct. 20, 1945, p. 584).You state that "there appears to be no basis for preference for water over isotonic solution of sodium chloride." I can think of at least three conditions in which this statement would not apply and, indeed, might even lead to danger. First, water is preferable in any condition in which there is deprivation of water alone, e. g., for a patient who is unable to replace water lost as insensible perspiration and from the lungs. This leads to dehydration, which involves some loss of electrolyte, but in general is associated with a retention of salt, or hypertonicity of the body fluids. True replacement therapy in such a case would consist in the injection of water with only a small amount of

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