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Edgar J. Schoen, MD
Kaiser-Permanente Medical Center Oakland, Calif University of California San Francisco

JAMA. 1984;251(1):37-38.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

THE JOURNAL's recent consideration of inappropriate laboratory tests^1-3 brings back memories of 1947, Bellevue Hospital, CSF chloride, and noted pediatric clinician Edith Lincoln, whose clinical and teaching skills had a lasting effect. I was a junior medical student assigned to Bellevue's pediatric tuberculosis service in the mid-1940s, one of the largest of its kind in the country. In an era when tuberculous meningitis was a common CNS infection, classic teaching held that a low CSF chloride value was almost pathognomonic of this severe disease. Dr Lincoln taught otherwise; her studies showed that low CSF chloride values simply reflected total-body chloride depletion and hypochloremia secondary to prolonged vomiting. We were told that CSF glucose and protein determinations were helpful in assessing the course of tuberculous meningitis but that CSF chloride determination was worthless.^4,5

Her data, experience, and authority were convincing: those passing through the Bellevue . . . [Full Text PDF of this Article]

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