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August 10, 1946

Current Comment

JAMA. 1946;131(15):1214. doi:10.1001/jama.1946.02870320032014

DEHYDRATION PLEURITIS  The phenomenon of tissue dehydration continues to arouse interest as a causal or contributing factor in many clinical syndromes. Armanino and Ory1 have shown that pleural injury with fibrinous exudate as judged by respiratory pain and friction rub may occur as one of the complications of dehydration in diabetic precoma. While cultures of the pleural exudate were not made, the absence of fever and the prompt disappearance of pain and friction rub on rehydration indicate that the authors were dealing with a so-called sterile pleuritis in which the relative lack of interpleural and intrapleural liquid played an important part. Doubtless a review of old necropsy records of the preinsulin era may disclose negative cultural results of fibrinous serous exudates in the severely dehydrated patient, Infection, of course, is not a sine qua non of the inflammatory reaction. Cell necrosis is all that is needed; dehydration should be