Among the early mental signs of interstitial nephritis is an explosive temper. Fits of hilarity and weeping may alternate (first pointed out by Clifford Allbutt). The costal cartilages ossify generally before the sixth decade and this is often premature. A hobby may no longer avail to preserve mental activity, and “the golf ball to-day is not seldom one of the beneficent agencies for this purpose.” Cirrhosis of the liver is longer averted in the patrician than in the plebeian because the laborer becomes senile sooner than others owing to his life of strain in all weathers. In arthritis, the nodosity of joints, especially in the fingers, in the form of _Heberden’s_ nodes, is thought by some an indication of longevity. They are often found in those who have few classical symptoms of gout and few reach eighty or ninety without these trophic changes. Dupuytren’s contractures and the camptodactylia of Landouzy, or incurved little finger, are among indications of a gouty habit and are not truly rheumatic lesions. Indolence of the bladder does not imply prostatic symptoms. Very common are widespread catarrhal disturbances, as for example, tussis senilis, with much flux of mucus, often rich in sodium chloride. Fits of sneezing, also of hiccough and even gaping, are frequent. The main treatment for early senility is physiological righteousness (Sir A. Clark). We must especially know the degree of vigor, of vitality, and specific habit of body. We must pay attention to the degree of blood pressure and early indications of renal inadequacy, orthostatic albuminuria, the tendency to epistaxis, and maintain as our keynote moderation in all things. The best idea is that of universal service which would bring all the world together on a high plane. The author refers with a good deal of skepticism to Metchnikoff’s Bulgarian bacillus but mentions Saundby’s book with great praise.