“We are told that to act thus directly upon the vessels is but to treat a symptom, and is therefore absurd. But whatsoever be our judgment on this or any such particular effect, the common denunciation of treating symptoms, which sounds very philosophical, is surely but a parrot phrase. Why should we not treat a symptom? If in granular kidney by mere pressure reduction the grievous headache be abated, or in angina pectoris the pain be thus charmed away, we have so far at any rate a substantial gain. “In renal diseases it is generally agreed that, on the whole, with due caution, to lower pressure is helpful. Moreover, if by mitigation of his suffering the patient gets a chance of picking up in many other ways, are we not more than justified in our interference, narrow as it may seem? We never know what interference may cut a link in a vicious circle. If we cannot stop the crack in the water-pipe, we need not throw away the mop. “The warning should run not against the treatment of a ‘mere symptom,’ but lest, while giving our attention to the symptom and snatching at an immediate advantage, we lose our grip of the case as a whole.” In whatever treatment we adopt for sclerosis, we must bear in mind that, under the raised pressure, the heart is very apt to dilate. To lower pressure alone in this condition often ends in failure. We must brace up the heart at the same time as we lower resistance. For the purpose strophanthus in large doses and strychnia are the best drugs. Digitalis is occasionally necessary, but more often does harm than good. Given, however, in this well-tried old form it contracts the ventricle without raising pressure: ℞ Pulv. Digitalis .. .. gr. 1–2 Pil. Hydrarg. .. .. gr. 1 Pil. Scillæ Co. .. .. gr. 1-1/2 Ft. pil. to be taken twice a day. The compound gland tablet that I chiefly use has this formula: ℞ Thyroid Extract dried .. gr. 1/2 Orchitic Extract dried .. gr. 1/2 Ovarian Extract dried .. gr. 1/2 Anterior Pituitary dried .. gr. 1/2 Ft. tab. 1. This can be taken three times daily and acts best, I think, if taken before food. The amount of thyroid can be doubled if necessary. In cases where there is much prostration the anterior pituitary can be increased to 2 grains. The orchitic and the ovarian can be omitted if thought advisable. Hitherto many of us have looked on this condition, arterio-sclerosis, as a tenant’s fixture, to be got rid of only when he moves into his next habitation. This is neither fair to ourselves nor to our patients. It is a hopeless stultification of our more recent physiological knowledge and discoveries. It is a pessimistic faith that deserves failure and gets it. It is a silent denial of those healing powers which Christ so lovingly displayed when on earth, and which are still the heritage of those who can see and believe. _Printed in Great Britain by_ UNWIN BROTHERS, LIMITED WOKING AND LONDON