MC CLAUGHRY 

 DISCUSSION 



MONCRIEF: I want to echo Dr. McClaughry's comments about 

 retrospective studies, particularly clinical situations. They really 

 have very little value because of the absence of the data that 

 you are looking for in the clinical records. We have, I feel, 

 probably one of the most exhaustive sources on clinical ma- 

 terial and data collections anywhere in the country because we 

 have a relatively small unit and a large number of personnel. 

 Although a patient has been in the hospital two months and may 

 have a clinical summary the size of a small telephone book, 

 it still does not have the data in it we want in the future, and 

 retrospective study is only valuable if the data that is contained 

 in your records is positive; then it may be of some value. If 

 it is negative, it may be that the doctor who made up the sum- 

 mary just left it out, or he may have observed it but did not 

 put it down in the records, so the only thing you can say with 

 retrospective study is whether something occurred. You can- 

 not say it did not occur, nor can you say what you think occurred, 



MARCUS: I think since Dr. McClaughry is dealing with nega- 

 tive results in terms of effect of exposure to cold on infectious 

 disease, that we might ask him to comment about the subject 

 of medical- surgical use of hypothermia which has, at least 

 as near as I can make out from a very superficial inspection 

 of surgical literature, also given negative results with regard 

 to infections. Of course, there are circumstances involved here 

 which, again, are mitigating in terms of preventing infection, 

 but I still think it deserves some comment as an aspect of the 

 negative results that you surveyed. 



McCLAUGHRY: I think we can have fun with the reports of 

 Dr. Blair and Col, Moncrief. In a pre-planned study, it is pos- 

 sible to measure and record the amount of cold exposure, along 

 with body temperatures, and then follow the incidence and course 

 of infectious diseases. Also, the bacterial and viral flora of 

 persons exposed to cold can be studied. 



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