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Alvan L. Barach, M.D.
AMA Arch Intern Med. 1955;95(1):174. doi:10.1001/archinte.1955.00250070190024.
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To the Editor:  —The paper "Management of Congestive Failure" by D. A. Rytand, M.D., is too misleading in respect to the use of oxygen in cardiac failure to allow it to stand without question.Oxygen therapy is among the most valuable agents in the treatment of chronic cor pulmonale. When administered in small and gradually increased oxygen concentrations, the adverse effects of abrupt inhalation of high concentrations are generally prevented, as has been repeatedly emphasized since 1938. The use of 100% oxygen has not been advocated by any responsible investigator for the treatment of pulmonary emphysema, with or without cor pulmonale.The value of 40 to 50% oxygen in the treatment of left ventricular failure in cases of hypertensive and coronary artery disease was also established in the studies of Richards and the author, in which it was shown that relief of dyspnea was accompanied by a decrease in the


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