AS A CLINICIAN of the past seeing present day medicine through the clinical and investigational eyes of today as delineated in medical journals, I have gained the idea that, to those particularly interested in the circulatory system of man, the myocardium has been losing clinically in its interest, with the exception of its consideration as a terrain for changes in electrical potential which are traced in, and interpreted from, electrocardiograms of many leads. This attitude does not seem to me to be justified, when we give consideration to the complexity of structure and function of the myocardium and their potentiality to be influenced by conditions of disease in man. Some of my younger colleagues decry my frequent usage of the term "myocardial insufficiency" and my belief in its clinical importance. To me myocardial insufficiency is a condition in which "there is evidence during life of failure of the heart muscle