In Reply to Reply.—
I thank Dr Westerman for his response and I don't disagree with it; however, at his suggestion, I offer a short addendum. Although, as he stated, the armed forces studies of heat stress have no direct application to GI tract disease, the armed forces also have done the following extensive, pioneering studies of GI tract diseases themselves, and some of these studies formed the basis for the very procedures under discussion.For example, a device for the nonsurgical biopsy of the intestinal mucosa, invented by Crosby and Kugler,1 described 25 years ago made a histological assessment of the conditions of patients with various GI tract diseases possible. This approach proved critically important in cholera, which was described previously in pathology texts as having necrotic and presumably nonabsorptive intestinal mucosa. Intravenous (IV) fluids were used when available, but the amounts and types required could not be
Meroney WH. Oral Solutions for Fluid and Electrolyte Replacement-Reply. JAMA. 1983;249(4):474. doi:10.1001/jama.1983.03330280024018
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