Excerpt from The Early Diagnosis of Heart Failure: And Other Essays on the Heart and Circulation

This volume consists of separate essays dealing mainly with Heart Failure.

Its aim throughout is to help the practitioner, when at the bedside of his patient, by suggesting to him new methods of observation which give fresh insight into the mode of the heart's action in health and disease.

The book traverses ground that is more or less new, since it recognises types of cardiac failure which are often ignored (in their early stages at least), and indicates certain methods of clinical diagnosis - some of them simple - which do not receive full description, and in several instances are not treated of at all, in the ordinary text-books upon the heart.

For example, such conditions as 'high diaphragm' and diminution in the area of liver dullness' are rarely looked for as signs of diminution of the total volume of blood in circulation; nor is this lessened volume of circulating blood generally recognised as a sign of myocardial weakness.

Therefore, in advancing new theories, advocating new methods, and dealing with matters not hitherto regarded as of proved clinical importance, it is incumbent on the author to bring forward at the same time adequate clinical evidence in their favour. Hence the numerous diagrams and details of cases which are introduced.

Practically no reference is made to the work of other observers, and for this defect the writer would fain apologise. But, considering that he has found it difficult to compress within reasonable limits the results of thirty years' clinical observations upon the heart, it is evident that the introduction and discussion of the work of others would have unduly ih creased the size oi the present volume.

As the essays have been written at various times during the last twenty years, and deal with subjects closely related to each other, it is inevitable that there should be a certain amount of repetition; no attempt has been made to remedy this, the writer preferring that each essay should remain individually complete.

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