In acute slowing of the heart, as in syncope, the patient must immediately lie down with the head low, possibly with the feet and legs elevated, and all constricting clothing of the abdomen and chest should be removed. Whiffs of smelling-salts may be given; whisky, brandy or other quickly acting stimulant, not much diluted, play also be given. Camphor, a hypodermic dose of strychnin or atropin if deemed necessary, a hot-water bag over the heart, and massaging of the arms and legs to aid the return circulation, are all means which are generally successful in restoring the patient's circulation to normal. Caffein is another valuable stimulant, perhaps best administered as a cup of coffee. Digitalis is not indicated: neither is nitroglycerin, unless the slow heart is due to cardiac pain or to angina. Some patients have syncopal attacks with the least injury or with any mental shock. Such patients as soon as restored are as well as ever. Other patients who faint or have attacks of syncope should remain at rest on a couch or bed for some hours. A tangible cause, being discovered for an unusually slow heart is sufficiently indicative of the treatment not to require further comment. While generally toxins from intestinal indigestion make a heart irritable and more rapid, sometimes they slow a heart, and in such cases the heart will be improved when catharsis has been caused and a modification of the diet is ordered. PAROXYSMAL TACHYCARDIA This condition is generally termed by the patient a "palpitation," and palpitation of the heart is recognized by most physicians as meaning a too rapidly acting heart, the term "tachycardia" being reserved for an excessive rapidity of the heart. Many of the so- called tachycardias are really instances of auricular fibrillation or flutter. Some persons normally have a pulse and heart too rapid; children more or less constantly have a heart beat of from 90 to 100. Women have more rapid heart action than men, and it becomes more rapid with their varying functions, specifically increasing its rapidity before, and perhaps during, menstruation. Many patients have a rapid heart action with the slightest increase in temperature and in any fever process. Some have a rapid heart action after the least exertion without any cardiac lesion or assignable excuse for such rapidity. Others have a rapid heart with mental activity and excessive excitement. Therefore in deciding that a heart is abnormally rapid one must individualize the patient.