FLUID IDEAS AND RIGID TERMINOLOGY

[摘要] During the past 40 years many investigators have contributed to the development of modern fluid therapy. However, Gamble did more to bring the various ideas into a coherent picture of the behavior of body water and electrolytes than anyone. He was responsible for many of the fundamental concepts. His way of looking at extracellular fluids was his great contribution and provides the basis for modern fluid therapy.He was one of the greatest medical writers, showing a rare ability of expressing his ideas in words and a superb facility in designing appropriate diagrams to illustrate complex relationships. Nevertheless, recent medical students are often confused by the meanings of the terms, acid and base, in his papers and have difficulty in following his description of the regulation of acid-base equilibrium. The confusion is understandable because acid and base are defined by Lowry1 and Brönsted2 in a way that gives these terms an almost opposite meaning. However, present definitions do not indicate that these terms were incorrectly used in the past.Words often take on new meanings—even completely contrary ones. Until very recently, practically all medical writers discussed body water and electrolytes using the same terminology and concepts as Gamble. Much will be lost to modern medicine if the original papers of this period are considered misleading or incomprehensible owing to a difference in terminology. For this reason it is important to re-examine the basis of fluid therapy as developed by Gamble in the light of contemporary chemical concepts and terminology.When Gamble started his life work in 1910, the essential basis for our understanding of the behavior of solutions of electrolytes was established.

[学科分类] 儿科学