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a study of the latter method. In the form of an apparatus first developed in this country by Starr and his colleagues (2), the ballistocardiograph was designed to measure cardiac output. In normal resting subjects a reasonably satisfactory agreement with cardiac output measured by other techniques was obtained (3, 4). However, the validity of the ballistic record as a measure of cardiac output has been questioned on theoretical grounds (5). When applied experimentally to abnormal circulatory states, moreover, considerable and sometimes wide discrepancies with values obtained by the direct Fick method were found. In traumatic shock, with rapid pulse rates, Cournand and his associates (6) encountered instances in which the ballistic record indicated a markedly increased cardiac output, whereas by the more reliable direct Fick procedure, the actual cardiac output was equally markedly decreased below normal. It was as if the systolic movement of the rapidly beating but relatively empty heart in the presence of a marked reduction of the systemic peripheral resistance produced a ballistic impulse closely simulating that resulting from a large blood ejection. Extensive further studies, especially by Starr and his colleagues, have led them to the conclusion that the relation between the ballistic record and cardiac output is "a distant one," and that the

COMPARISON OF CARDIAC OUTPUT DETERMINED BY THE BALLISTOCARDIOGRAPH (NICKERSON APPARATUS) AND BY THE DIRECT FICK METHOD 1