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August 12, 1939


JAMA. 1939;113(7):615. doi:10.1001/jama.1939.02800320067025

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To the Editor:—  A common method of connecting the patient to apparatus for a basal metabolism test is by means of a rubber mouthpiece. The nose is closed by means of a nose clip. With some patients this works very well but with many patients with large or irregularly shaped nostrils the clip has to be made extremely tight and set just so or a leak occurs.The apparatus may provide a shiny metal mirror for testing for leaks, but after the nose clip is adjusted the patient may wrinkle the nasal muscles and change the position of the clip sufficiently to cause a leak to occur again.This leak invariably causes a "high" reading. Also a tight nose clip gives the patient as much discomfort as any other part of the procedure, if not more.The following simple addition to this procedure will prevent this leakage: Before the nose

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