During convalescence, the skin over the heart may be painted with iodin, repeated often enough to cause stimulation without injuring the skin; it seems at times to be of value. Various iodin or iodid ointments have been used, but they probably have no more value than the administration of small doses of iodid. Systemic Treatment.--As this complication most frequently occurs during acute rheumatism, the question arises as to the value or harmfulness of salicylates and alkaline drugs. With our recent better understanding of the action on the heart of pure salicylates (either natural or synthetic saliclic acid, which have been shown to act identically, if equally pure), we must believe that in any ordinary dosage they will injure the heart but rarely. While salicylic acid will not prevent endocarditis, it should he continued, if it is of benefit with regard to the arthritis. The indication for its use depends on its effect on the joints. As it acts at times almost as a specific in rheumatism, it would seem that it should be of value in the endocarditis caused by rheumatism. On the other hand, the endocarditis occurs during the second or third week of acute rheumatism, after the blood has been thoroughly saturated with salicylic acid. Therefore it certainly does not tend to prevent rheumatic endocarditis; hence for this complication alone salicylic acid is not indicated. ALKALIES Anything which tends to increase the acidity of the tissues and to diminish the alkalinity of the blood, whether from starvation or outer causes, seems to pro-duce endocardial and myocardial irritation, if not actual inflammation. Therefore in a disease like rheumatism, which seems to be made worse by anything which increases the acidity, alkalies are obviously indicated, and it is probable that an increased alkalinity of the blood tends to prevent endocardial irritation, and may soothe an inflammation already present. Until we have some positive knowledge to the contrary, alkalies should be freely administered during endocarditis, especially during rheumatic endocarditis. Potassium citrate in 2 gm. (30 grain) closes, in wintergreen water, should be given every three to six hours, depending on how readily the urine is made alkaline. This may be given with the salicylic acid treatment, and also when the salicylic acid has been stopped. It may be well, if sodium salicylate is being used, to give also sodium bicarbonate, the sodium bicarbonate often preventing irritation of the stomach from the sodium salicylate, the dose being equal parts of the sodium salicylate and the sodium bicarbonate administered in plenty of water. If some other form of salicylic acid is preferred, novaspirin, which is methylene-citryl-salicylic acid and contains 62 percent of salicylic acid, is perhaps the least irritant to the stomach of the salicylic preparations. This drug is decomposed in the intestine into its component parts, salicylic acid and methylene-citric acid.