As the complications and results of arteriosclerosis come to the front every one must be considered by itself and as if it were the true disease. There may be a slight apoplectic attack from which the patient fully recovers, but the prognosis is now of a grave character, as the chances are that another attack may supervene and carry off the subject. Yet, after an apoplectic attack, patients have lived for many years. Probably the most noted illustration of this is the life of Pasteur. He had at forty-six hemiplegia with gradual onset. He recovered with a resulting slight limp, did some of his best work after the stroke, and lived to be seventy-three years old. Yet the exception but proves the rule and the prognosis after one apoplectic stroke should always be guarded. The first attack of cardiac asthma is to be looked upon as the beginning of the end. The end may be postponed for some time, but it comes nearer with every subsequent attack. One may recover from what appears to be a fatal attack of cardiac asthma accompanied by edema of the lungs and irregular, intermittent, laboring heart, but the recovery is slow and the chances that the next attack will be the fatal one are increased. The significance of albuminuria is difficult to determine. The kidneys secrete albumin under so many conditions that the mere presence of albumin in the urine may have but little prognostic value. Many cases are seen where there is no demonstrable albumin, and yet the patient may suddenly have a cerebral hemorrhage. As a general rule the urine should be carefully examined, but not too much stress should be laid on the discovery of albumin and casts. It is not always possible to determine the extent of the kidney lesion by the urinary examination, yet at any time a uremic attack may appear and prove fatal. After all the most important fact for the patient is not what the pathologist finds in his kidneys after he is dead, but what the living functional capacity of the kidneys is. This can now be determined in a variety of ways as the result of extensive work carried out in quite recent years. The simplest method of determining the functional capacity of the kidneys is by the injection into the muscles of the back of a solution containing 6 mg. of the drug phenolsulphonephthalein in one c.c. of fluid. This comes already prepared in ampules, with full directions for its employment.[16] Some clinicians use indigo-carmine in place of phthalein. The general consensus of opinion is in favor of phthalein. [16] I have found the small colorimeter made by Hynson, Westcott and Dunning, Baltimore, Mo., costing $5.00, a very practical instrument. The nephritic test meal carefully worked out by Mosenthal[17] gives much valuable information. The determination of the nonprotein nitrogen or the creatinin in the blood also reveals the functional capacity of the kidneys.[18] [17] Mosenthal, H. O.: Arch. Int. Med., 1915, xvi, 733.