Dehydration

One alternative title frames illness as thirst rather than sickness. The book's central thesis discourages treating thirst with medications. Dehydration and delirium can reinforce each other: dehydration can cause delirium, while delirium reduces oral intake and worsens dehydration. Dehydration is defined as a deficit of total body water that may result from poor fluid intake, increased insensible or pathological losses, or a combination of both. Dehydration causes cells throughout the body to shrink because of fluid loss. The article identifies dehydration as the primary cause of a thinned stomach lining. The mucosa cannot maintain its protective thickness without adequate water. The body tolerates food deprivation far longer than water deprivation because it can draw on stored fat reserves for energy. Low sodium prevents the body from maintaining adequate extracellular fluid volume, resulting in dehydration. Dehydration can present as hypertonic or isotonic depending on the relative depletion of sodium and water, with slightly different treatment implications. Dehydration is a fluid volume deficit independent of electrolyte concentration; without adequate fluid, there is insuffi…