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1. 1. The ballistocardiogram, as recorded by the photocell displacement apparatus (modified after Dock), was investigated in a consecutive group of eighty normal control subjects. 2. 2. In the series of normal subjects, the ballistocardiogram was found to be normal at rest in seventy, abnormal in seven, and borderline in three. The significance of these findings has been discussed. 3. 3. Of fifty-three normal controls with normal resting ballistocardiograms who were exercised, the ballistocardiogram in forty-eight remained normal after the double “2-step” test. A careful follow-up study of the normal subjects with abnormal ballistocardiograms will be made in order to determine the clinical implication of these findings. 4. 4. The unhinged photocell displacement ballistocardiogram apparatus was employed with a simple method for simultaneous recording of the electrocardiogram with the commonly employed single-channel cardiographic machines.

The influence of hydration, of elastic bandaging of the lower extremities and of adrenal cortical insufficiency upon the renal retention of water, sodium and chloride associated with upright posture was studied. With ‘moderate hydration,’ the excretion of both water and electrolytes diminished when the subjects changed from the supine to the sitting position. With ‘intense hydration’ only electrolyte excretion diminished when the subjects sat up. Compression of the superficial veins of the lower extremities with elastic bandages diminished the expected postural antidiuresis and antisaluresis. Patients with treated adrenal cortical insufficiency did not demonstrate any antidiuresis when the sitting position was assumed. Submitted on December 12, 1955

ectorcardiographic studies of QRS loops in right bundle branch block (RBBB) have been reported by many authors, and the classic abnormalities are discussed in texts and symposium proceedings.l-6 The T loop in RBBB has received scant attention thus far, except for Chou and associates’g who reported the incidence of abnormal T loop wideness in 10 per cent of RBBB cases. The rotational characteristics of T loops in RBBB, as encountered in ischemic heart disease, in right ventricular enlargement, and in healthy persons have not been explored. The purpose of this investigation was to survey T-loop characteristics in a series of patients whose RBBB was of diverse etiology.

In the presence of previous myocardial infarction, the direct ballistocardiogram is abnormal in approximately 80 per cent of the cases. Following the coronary occlusion, a normal ballistocardiogram is relatively rare in patients with angina pectoris as compared with those who are asymptomatic. There is no correlation between the ballistocardiographic patterns and the persistence of electrocardiographic evidence of myocardial infarction. The prognostic significance of the ballistic findings reported will be determined by long-term follow-up studies.

IT would be highly desirable to obtain a diuretic agent that could be given orally and yet act as effectively as parenterally administered mercurial diuretics, without producing significant toxic mani-festations. The xanthine diuretics,1 , 2 chemically related uracil derivatives3 , 4 and other preparations of mercurials5 , 6 have been ineffective, inconstant in effect or associated with unpleasant side actions or toxicity. Recently, additional mercurial diuretics for oral administration have been tested in patients with heart failure.7 8 9 Another approach to the development of a satis-factory oral diuretic is based on the observation that inhibition of carbonic anhydrase activity in renal-tubule cells not only impairs the tubular . . .

The vectorcardiographic findings in 29 patients with mitral stenosis are presented. Five patients had normal QRS loops, and five had classical loops of right ventricular hypertrophy with predominant anterior forces. The remaining 19 patients had posteriorly oriented loops with normal rotation. The characteristics of these latter loops were analyzed in detail and compared with the findings in series of normal subjects. The midportions of the horizontal plane QRS loops were found to be significantly more posterior in orientation. Posterior voltage was increased while maximum QRS voltage was decreased. It was thought that the findings represent early right ventricular hypertrophy, and quantitative criteria to differentiate these loops from normal are suggested.

THE EXACT nature of essential hypertension has not been clearly established, and, as a result, many drugs, diets, and operative procedures have been used in the treatment of this disease. In most instances therapy has either proved more annoying to the patient than the disease itself or produced variable results. The numerous theories regarding the etiological basis of essential hypertension have been summarized repeatedly by many authors,1but at present most observers agree that there are probably both neurogenic and humoral factors that produce and maintain blood pressure in certain persons at a hypertensive level. A great deal of the treatment has been aimed at controlling or eliminating the neurogenic factor, for the exact humoral mechanism that operates in hypertension has still not been clarified. Other drugs have been used because of their direct action upon the vascular system. Therapy with thiocyanate derivatives has been employed for years, and

Seventy-eight patients with well-documented inferior infarction were studied by the Frank vectorcardiographic technic. The commonest residual was superior and leftward orientation of the early forces that moved clockwise in the frontal projection. Quantitative data on the duration, magnitude, and leftward sweep of these forces are presented. In 52 cases, the entire frontal loop was clockwise. When sagittal loop reversal, partial or total, ocurred in this group, a high correlation with associated anterior infarction or left ventricular enlargement was noted. In 24 patients, the returning frontal limb was deformed due to upward bowing. When anterior forces were well preserved in the presence of this deformity, a characteristic "pollywog" shape in the sagittal loop resulted. Conduction defects were twice as common in the cases with mid-loop frontal deformity as in the cases without such defects. Anterior forces of prominent voltage and prolonged duration were noted in 19 cases. Quantitative data on these cases, presumably reflecting associated posterior infarction, are presented. The vectorcardiographic residua of inferior infarction may be classified according to rotational characteristics of the frontal and sagital loops. Classification may be of value in providing clues to associated anterior disease, left ventricular enlargement, and conduction defect.

THAT the coexistence of two metabolic disturbances such as thyrotoxicosis and diabetes mellitus can cause an increased severity in both conditions has long been recognized.1 These two conditions reach their most extreme states in the form of thyroid crisis and diabetic coma. The recent treatment of a case combining these two extremes has prompted the writing of this report. Joslin and his co-workers have emphasized the high incidence of glycosuria and hyperglycemia in patients with hyperthyroidism.2 In a large number of thyrotoxic patients they found that one third had fasting blood-sugar levels of over 130 mg. per 100 cc. Because . . .

In the absence of a clear-cut history and definite physical findings, the diagnosis of coronary artery disease often becomes a difficult task for the clinician. In the search for supplementary objective evidence, various tests have been developed as aids in the diagnostic study of these patients. The electrocardiogram has been most widely employed for this purpose. However, the resting electrocardiogram is of value only when it shows abnormalities, and it has been well established that a large percentage of patients with coronary artery disease have normal resting electrocardiograms.1In 1929 Master and Oppenheimer2introduced a test for circulatory function based on the response of the blood pressure and pulse to standard exercise. Subsequently these standards of exercise were employed to determine the effect of exercise on the electrocardiogram in patients with angina pectoris.3Considerable experience has now been obtained in the use of the Master "two-step" exercise