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August 12, 1974

Lye Ingestion

Author Affiliations

Marshfield, Wis

JAMA. 1974;229(7):765. doi:10.1001/jama.1974.03230450015008

To the Editor.—  The CLINICAL NOTE by Sperling and Wheeler, "An Unusual Complication of Lye Ingestion" (228:871, 1974), is marked by an apparent lack of appreciation of current concepts regarding the problem of accidental or suicidal lye ingestion.1,2 It follows from this that a more aggressive approach to the management of the patient may have been rewarding.3-6The problem of lye ingestion has undergone recent dramatic change since liquid lye in the form of household drain cleaners (Drāno [54% NaOH], Liquid Plumr [30.5% NaOH], Plunge [25% NaOH], and Open Up Drain Cleaner [40% KOH]) has become widely available. The ingestion of crystals of lye causes pain, and children commonly stop after a few crystals. Crystals also tend to adhere to the first tissues they reach. Adults bent on suicide commonly swallow crystals with water, thereby diluting the alkali concentration below 3N.4 Thus, crystalline lye injury tends to