A RECENT report on the pathogenesis of hypertonic dehydration with infantile diarrhea1 indicated that this metabolic disturbance seemed to be more frequent in Buffalo than reports in the literature suggest for other areas in the United States. This impression was confirmed in a review of 2,415 charts of patients under two years of age admitted to the Children's Hospital of Buffalo with acute gastroenteritis between 1954 and 1966. Of these charts, 455 contained data on sodium level in the serum before therapy. The sodium concentration was measured by flame photometry with an internal lithium standard. Stool cultures were negative for Shigella or Salmonella in all but three of the 455 infants.
The data are illustrated in the Figure and indicate that in 34% of the cases the sodium concentration was 151 mEq/liter or higher, and in an additional 14% in the borderline range between 145 and 150 mEq per