Edema, failing heart, perhaps aneurysms, peripheral obstruction, or hemorrhages are the final conditions in this chronic disease of arteriosclerosis. Riesman [Footnote: Riesman: Pennsylvania Med. Jour., December, 1911, p. 193.] divides hypertension into four classes hypertension without apparent nephritis or arterial disease; hypertension with arteriosclerosis; hypertension with nephritis, and hypertension with both arteriosclerosis and nephritis. These classes are given here in the order of the seriousness of the prognosis. ETIOLOGY One of the most common causes of hypertension is clue to excess of eating and drinking. The products caused by maldigestion of proteins, and the toxins formed and absorbed especially from meat proteins, particularly when the excretions are insufficient, are the most frequent causes of hypertension. Whatever other element or condition may have caused increased blood pressure, the first step toward improving and lowering this pressure is to diminish the amount of meat eaten or to remove it entirely from the diet. In pregnancy where there is increased metabolic change, when the proteins are not well or properly cared for in gout, and when there is intestinal fermentation or putrefaction, hypertension is likely to occur. The increased blood pressure in these cases is directly due to irritation of the toxins on the blood vessel walls. While alcohol does not tend to raise arterial blood pressure, in large amounts it may raise the venous pressure. Also, by causing an abundant appetite and thus increasing the amount of food taken, by interfering with the activity of the liver, and by impairing the intestinal digestion, it can indirectly disturb the metabolism and cause enough toxin to be produced to raise the blood pressure. Any drug or substance that raises the blood pressure by stimulating the vasomotor center or the arterioles, when constantly repeated, will be a cause of hypertension. This is particularly true of caffein and nicotin. Also, anything that might stimulate, or that does stimulate, the suprarenal glands will cause a continued high blood pressure. It is quite probable that in many cases of gout the suprarenals are hypersecreting and it has been shown by Cannon, Aub and Binger [Footnote: Cannon, Aub and Binger: Jour. Pharmacol. and Exper. Therap., March, 1912.] that nicotin in small closes increases the suprarenal secretion. Therefore, nicotin becomes a decided cause of hypertension and arteriosclerosis. Thayer found that heavy work is the cause of about two thirds of all cases of arteriosclerosis, and one of the functions of the suprarenals is to destroy the waste products of muscular activity; hence these glands, in these cases, are hypersecreting. Furthermore, the reason that many infections are followed later by arterio- sclerosis may be the fact that the suprarenals have been stimulated to hypertrophy and hypersecrete.