This small brochure gives an excellent summary of present-day knowledge concerning cardiac decompensation. Romberg and his assistants have critically summarized the observations on all their heart patients with acquired valvular lesions suffering with heart muscle failure (decompensation) entering their service in Munich. They have paid particular attention to the physiologic and chemical aspects of failure and have made a number of original studies in lactic acid, anoxemia and carbon dioxide content. The material was presented before the congress of the German Society for Internal Medicine for 1929 and will remain a noteworthy contribution to the subject to that date. It can be heartily recommended to all students, clinicians and physiologists interested in this difficult phase of valvular heart disease.