To the Editor:—
Dr. Wishnofsky uses an isolated, undetailed, general introductory sentence as a pretext to expound his viewpoint on matters with which I was not concerned in a 5-minute introduction to a panel on the treatment of heart failure. He makes 3 points:
Modern, powerful diuretics have salutary effects. I agree as suggested by the title of my communication.
Unless he is making some esoteric distinction between the terms "heart failure" and "congestive cardiac insufficiency," it is difficult to agree that diuretics should be administered in patients with mild heart failure, if they respond to limitation of activities, moderate reduction in sodium intake, and digitalization. To subject such patients to injections of organomercurials and the possible side effects of these and powerful oral diuretics appears unwarranted.
Primarily he is concerned with the superiority of diuretics over digitalis. My presentation assigned no relative values to individual therapeutic