ventilators were carefully closed, and the newcomers, with the rest, settled off to sleep and slept soundly for nearly four hours, with the exception of a few minutes' interval at Grantham. When aroused on nearing London they, like the other occupants of the compartment, were haggard and leaden-hued, their fresh color was entirely gone, and they looked and moved as if exhausted. I examined my own face in the lavatory mirror at the beginning and end of the journey and could see but little alteration in my color; if anything, it was rather improved by the end of the journey. The second case occurred early in 1897. I was asked to see a woman, aged about forty-eight years, who had been treated in a neighboring town for many weeks for bronchitis and asthma following influenza. She had relapsed about a week when I first saw her. She was then sitting up in bed; her face was leaden-colored, her skin was clammy and sweating, with a feeble, quick pulse, and the heart sounds were indistinguishable owing to wheezing; there was some crepitation at the bases. The temperature was about 101° F. The weather was cold, but after wrapping her up, with a hot bottle to her feet, the window was well opened. Her color improved in a few minutes and the sweating ceased soon after. But it and the blueness returned if the window was shut for any time. It was directed to be kept open night and day, and I could see from my house that this order was carried out. Although on one night the thermometer showed 14° F. of frost the chest was clear of noises and she was convalescent in eight days. If fresh air needs warming she ought to have died. Why do most men feel so tired after an afternoon's work in a crowded out-patient room? Why is a long journey in a full railway carriage, even with a comfortable seat, so exhausting to many people? Personally an hour or two in a full carriage with the windows shut will give me numbness in my feet and legs and knock me up for the day, while a railway journey in an empty carriage with open windows does not affect me at all. But most people will be willing to admit that any kind of crowd is tiring. It is to me difficult to resist the impression than an overdose of waste products, whether of one's own or other people's, must generally interfere with the metabolism of nerve tissue. Women as they grow older are apt to live much indoors. I believe the fat, flabby, paunchy woman, whether purple or pale, with feeble, irritable heart and "inadequate" kidneys, is usually the victim of rebreathed air. A "close" room will infallibly give me an abdominal distention and borborygmi within half an hour, and I am inclined to think the purity of the air breathed by the dyspeptic quite as important as his regimen or his teeth. It must, I think, sooner or later be recognized that many of the increasing ills which it has been the fashion to charge on the "hurry and brain fag" incidental to a high state of civilisation