In a recent communication from the Russell Sage Institute of Pathology1 the first satisfactory observations on the basal metabolism of patients with heart disease were reported. Sixteen patients with cardiac or cardiorenal disease were studied in the bed calorimeter at Bellevue Hospital, New York. An important result of the investigation was the close agreement found in the determination of the metabolism by the direct and indirect methods of calorimetry. Such an agreement, together with the finding of normal respiratory quotients, makes it probable that the metabolism in heart disease is not of an essentially abnormal type, and justifies the use of the indirect method in future work. It was furthermore shown that in patients with compensated cardiac lesions the metabolism was within normal limits, while in patients who had dyspnea while at rest in bed the metabolism was either normal or increased. "Of twelve patients with dyspnea, nine showed a