The positive effect of decomposition products in the intestine, more especially such as come from meat proteins, is well recognized; but the importance, in high pressure cases, of the absorption of toxins derived from imperfectly digested food remaining in the bowels over night is not sufficiently recognized. Patients with high blood pressure should not eat a heavy evening meal, and especially should they not eat meat. Willson [Footnote: Willson, R. N.: The Decomposition Food Products as Cardiovascular Products, THE JOURNAL A. M. A., Sept. 25, 1915, p. 1077.] well describes the condition caused by the absorption of these toxins. If the heart muscle is intact, he finds such absorption in high pressure cases will show diastolic as well as systolic increase: The vessels pulsate and throb; the skin is pale; the head aches; the tongue is coated; the breath is foul; vertigo is often distressing; and not infrequently the hands and feet feel distended and swollen. A thorough house-cleaning of the gastro-intestinal canal causes the expulsion of the offending substances and the expulsion of gas, whereupon the blood pressure often resumes its normal level and the symptoms disappear. Wilson suggests that not only the meat proteins, but also the oxyphenylethylamin in overripe cheese may often cause this poisoning; and cheese is frequently eaten by these people at bedtime. Of course if any particular fruit or article of food causes intestinal upset in a given individual, they should be avoided. When the heart is hypertrophied in disease, the cavities of the ventricles are probably also generally enlarged, and therefore they propel more blood at each contraction than in normal persons and thus increase the blood pressure. The blood pressure is raised not only by intestinal toxemia and uremia, but also by lead poisoning and the conditions generally present in gout. It has been pointed out by Daland [Footnote: Daland: Pennsylvania Med. Jour., July, 1913.] that nervous exhaustion may raise the blood pressure in those who are neurotic, and he finds that this hypertension may exist for months in some cases. On the other hand, in neurasthenics the blood pressure is generally lowered. As he points out, there is often a very great increase in the systolic blood pressure at the menopause, while the diastolic pressure may not be high. This makes a very large pressure pulse. This suggests the possibility of disturbances of the glands of internal secretion. This hypertension is generally improved under proper treatment.