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January 13, 1940


JAMA. 1940;114(2):178. doi:10.1001/jama.1940.02810020082022

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To the Editor:—  In The Journal Nov. 25, 1939, appears correspondence from Dr. Alvan L. Barach, New York, criticizing my clinical lecture in the panel discussion of pneumonia as "inadvertently and unfortunately misleading." Dr. Barach is a nationally known expert in the field of oxygen therapy. I agree entirely with his points pertaining to pathogenesis of anoxia and the methods of relieving it, but I disagree with his estimate of what is important in treating pneumonia.When I made the statement that "cyanosis is the main and only important indication for oxygen therapy in pneumonia" I was aware of the fact that in severe anemia cyanosis cannot develop and that in circulatory failure cyanosis is sometimes masked by pallor. But, when either of these circumstances complicates the treatment of pneumonia, oxygen therapy is unimportant because it can do little good as compared with other measures more clearly indicated. Of the

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