It is now very frequent for the physician, in his office, to hear the patient say, "Doctor, I am not sick, but just tired," or, "I get tired on the least exertion." We do not carefully enough note the condition of the heart in our patients who are just "weary," or even when they show beginning cardiovascular-renal trouble. The primary symptoms of this condition of myocardial weakening are slight dyspnea on least exertion; slight heart pain; slight edema above the ankles; often some increased heart rapidity, sometimes without exertion; after exertion the heart does not immediately return to its normal frequency; slight dyspnea on least exertion after eating; flushing of the face or paleness around the mouth, and more or less dilatation of the veins of the hands. All of these are danger signals which may not be especially noted at first by the individual; but, if he presents himself to his physician, such a story should cause the latter not only to make a thorough physical examination, but also to note particularly the size of the heart. It a roentgenographic and fluoroscopic examination cannot be made, careful percussion, noting the region of the apex beat, noting the rapidity and action of the heart on sitting, standing and lying, and noting the length of time it takes while resting, after exertion, for the speed of the heart to slacken, will show the heart strength. Slight dilatation being diagnosed, the treatment is as follows 1. Rest, absolute if needed, and the prohibition of all physical exercise and of all business cares. 2. Reduction in the amount of food, which should be of the simplest. Alcohol should be stopped, and the amount of tea, coffee and tobacco reduced. 3. If medication is needed, strychnin sulphate, 1/40, or 1/30 grain three times a day, acid the tincture of digitalis in from 5 to 10 drop doses twice a day will aid the heart to recover its tone. Such treatment, when soon applied to a slowly dilating and weakening heart, will establish at least a temporary cure and will greatly- prolong life. If these hearts are not diagnosed and properly treated, such patients are liable to die suddenly of "heart failure," of acute stomach dilatation, or of angina pectoris. Furthermore, unsuspected dilated hearts are often the cause of sudden deaths during the first forty-eight hours of pneumonia.