To the Editor.
—The Archives article entitled "Thermoregulatory Failure Secondary to Acute Illness" (139:418-421, 1979) by Drs Whittle and Bates deserves two comments. First, except possibly for case 3, the 26-year-old man admitted to the hospital following a chlorpromazine hydrochloride overdose, all other patients described were suffering from an acute illness superimposed on chronic organic diseases such as chronic obstructive lung disease (case 1), chronic renal failure (case 2), chronic renal failure and cerebrovascular disease (case 5), diabetes mellitus (case 4), and severe congestive heart failure (case 6). Therefore, the discussion may apply to chronically ill medical patients who become decompensated and not necessarily to acute medical illness. Hypothyroidism is, in our experience also, an uncommon cause of hypothermia. In fact, in our intensive care unit the most common cause of hypothermia is sepsis in association with chronic renal failure, protein calorie malnutrition (PCM), cirrhosis, and immunoincompetence.The second point