As mild endocarditis rarely occurs primarily but is almost always secondary to some acute disease, its immediate treatment is only a slight modification of that of the disease which is causing it. A complication which is so frequent should always be expected, and consequently warded off or prevented, if possible. Knowledge of the diseases which are most liable to cause endocarditis makes frequent heart examinations a necessity, to note when it arrives. While an extra heart tire, sleeplessness, and the circulation of unnecessary toxins from a bad condition of the bowels and from improperly selected food all make this complication more liable, its occurrence is, nevertheless, often unpreventable. The most efficacious preventive pleasures are sleep, rest, the stopping of pain, prevention of exertion, proper food which does not cause flatulence or other indigestion, good, sufficient daily movements of the bowels, the prevention of intestinal distention, and maintenance of a clean, moist surface of the body, produced by such sponging and bathing as the temperature demands. The disease having developed, the indications for treatment are really few; in fact, the treatment is mostly negative. There is generally but little local pain; the temperature from simple endocarditis alone is not high and the acute symptoms tend to abate. Local Treatment.--Endocarditis having been diagnosed, especially if there is palpation or pain, an ice bag over the heart is often of considerable value, but not so efficient as in pericarditis. It often tends to quiet the heart, and may be of some value reflexly in slowing the inflammation. If it causes restlessness, however, and does not lessen the pain (which in some instances it may increase), it certainly should be stopped. Children, in whom this complication so frequently occurs, generally do not bear the ice bag well. Sometimes it may be advisable to substitute warm applications, and often a great deal of comfort is derived from them, the patient soon going to sleep. One of the greatest values of either cold or hot applications is diminution of the discomfort from the cardiac disturbance, and the stopping of any pain which may be present. If they do not do this, there is no object in using either cold or heat. The discomfort from blisters over the heart during the acute stage of endocarditis is greater than any good which they can do. In adults a few small blisters may be used intermittently around the borders of the heart, after the acute symptoms are over, to act reflexly on the heart and possibly aid absorption of inflammatory products. Sometimes improvement seems to follow such treatment; it certainly can do no harm.