The literature contains extremely few reports of observations on the metabolism of patients with heart disease. The work most frequently referred to is a monograph of Kraus.1This study of the effect of fatigue in various pathologic conditions contains observations on the gaseous metabolism of three cardiac patients while at rest and while working on an ergograph, together with analyses of the oxygen and carbon dioxid content of the venous blood in seven cases. The metabolism experiments were made with the Zuntz apparatus. One of the most striking results is the extraordinarily low value obtained in all cases for the respiratory quotient. In the two milder cases the quotients for experiments with the subjects at rest and fasting were 0.743 and 0.603, while three similar observations in the more severe case gave as respiratory quotients 0.574, 0.534 and 0.614. Exercise brought about a rise of the quotient. In