"'BASAL METABOLISM'—A DISCLAIMER OF RESPONSIBILITY"
Journal of the American Medical Association (JAMA)
mias. It was for the most part due to his efforts that we have our present clear insight into this abnormality. His statement that "the use of instruments tends to foster the idea that they reveal matters which are most important" is certainly very true. The lay mind and the professional mind as well are liable to be impressed-overimpressed, prob¬ ably-by polished metal and the photographic dark room, but this does not seem to be a proper reason for putting them aside. It is the duty of the
... the duty of the "cardiologist" to use these methods of examination whenever they are indicated, and to fight strongly against the charm of their impressiveness to keep the information which they give-and they do give informa¬ tion which can be obtained in no other way at present-in its proper place in the general picture of the case. It is true also, as Sir James says, that "the output of the heart is dependent upon the heart muscle." It is dependent on many other factors, though, for the peripheral resistance, the valve action, the respiratory function, the nervous system and even the body weight all have an influence on the effec¬ tiveness of the circulatory system, and may each contribute their part in the causation of circulatory failure. Without a thorough knowledge of the reason for failure in the given patient, we cannot take proper measures for its treatment, so that all of these systems must be investigated in some cases, and occasionally even the roentgen ray, most impres¬ sive of all instruments, will be called in to give information about the great vessels or about the lungs. My purpose is not to take issue with Sir James Mackenzie, for his point of view is exceedingly sound and does not differ greatly from that of many others ; but it seems that in decry¬ ing the indiscriminate use of instruments he has condemned all instrumental examination, and this is so far wrong that it should be plainly denied.