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Dr Harlan seems to have taken offense when none was given, but more unfortunately he has missed the central point of the article and its accompanying editorial. Both were meant to draw attention to a potentially preventable cause of morbidity and mortality. Carbon monoxide is responsible for almost half of all deaths from poisoning, and it is the most frequent cause of chemical asphyxiation.A major reason that several thousand people die every year from its effects is that carbon monoxide poisoning is not considered as often as it should be as a cause for unexplained coma. Dr Harlan illustrates that point when he says that after one person was found dead on the floor of a motel room with cherry-red livor mortis and another person lay a few feet away in coma, that carbon monoxide poisoning tended to be ruled out because they were found in an
Dan BB. Carbon Monoxide Poisoning in a Motel-Reply. JAMA. 1989;262(6):772. doi:10.1001/jama.1989.03430060065015
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