In Reply.—In response to Dr. Holmes' pertinent observations, let us say that we agree that the management of the first case was suboptimal. This points up the fact that in a large hospital with hundreds of attending physicians and dozens of house officers, a uniform approach to any selected disease rarely exists. The article, however, was not published on the pretense of describing the subtleties of therapy of hydrocarbon ingestion and never implied that the therapeutics described were to be "construed as standard care." The article makes no claim outside of reviewing the pertinent data on one selected aspect of the disease.
Nevertheless, we disagree that "all children who are symptomatic from hydrocarbon ingestion [should] be admitted to the hospital" (italics ours). This would imply that any child with slight fever or cough should be admitted regardless of time since ingestion, reliability of parents, access to medical care, or