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January 8, 1927


JAMA. 1927;88(2):118-119. doi:10.1001/jama.1927.02680280048026

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To the Editor:  —I find it difficult to accept some points in the article by Harrison and Blalock on this subject (The Journal, Dec. 11, 1926, p. 1984). I refer particularly to the implication that anemia injures the heart and the statement that digitalis is indicated in the treatment.1. These investigators, after mentioning the increase in the cardiac output, say: "This compensatory increase in the cardiac output is not without its disadvantages, as the overworked heart may finally succumb to the strain of prolonged increased work." I believe it is correct to assert that one of the contributions of the late Sir James Mackenzie is the refutation of the belief that the normal heart is injured by increased work. I am not aware of any reliable evidence that harmful effects may be ascribed to increased work of prolonged duration, and the literature contains many papers in support of the

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