FOR YEARS it has been repeatedly mentioned in the medical literature that the problems of parenteral nutrition would be augmented if adequate calories could be provided1 without overhydration of the patient. The work of Elman1b throughout the past few years has started an avalanche of studies pertaining to the value of electrolytes and parenteral nutrition for the patient who is unable to consume adequate food. His studies will go down, no doubt, in the annals of medical history as the beginning of one of the milestones in the advancement of the preoperative and postoperative care of the surgical patient.
In the earlier days of saline therapy the surgeon was not infrequently accused of having drowned the patient because of the use of too much fluid. It was soon learned that the offending factor was the use of excessive amounts of sodium chloride which caused a retention of water.