cerebral arteries is too great. Even in the early stages a careful watch should be kept on the kidneys. If albumen appears, it makes the prognosis more grave, but it should cause no despair. Mahomed and the early observers thought that kidney disease was almost inevitable sooner or later, but further experience has shown us that many cases live for years and then die without albuminuria. In other cases it is often transient and responds to treatment. Hitherto I have only dealt with systolic pressure, but the diastolic pressure in senility and sclerosis is a matter of much importance, and helps us both in treatment and prognosis. Brunton said: “The systolic pressure shows the maximum height to which blood pressure is raised by the wave of blood driven into the aorta by the contraction of the left ventricle. It thus indicates in a general way the strength of the ventricle. The diastolic pressure shows the minimum to which the blood pressure sinks during the interval when no blood is coming into the aorta from the heart, and the arterial system is emptying itself through the capillaries into the veins. It therefore indicates generally the degree of contraction or relaxation of the capillaries.” For practical purposes we want to know the pulse pressure, and this is roughly estimated by subtracting the diastolic from the systolic. A systolic pressure of 140 and a diastolic of 100 would give a pulse pressure of 40, which is about right. Any pulse pressure of over 40 points to hyper-tension, and under 20 to hypo-tension. The diastolic pressure is more constant than systolic pressure, and is not so susceptible to disturbing external influences; it is therefore a surer guide in estimating hyper-tension. A continuous diastolic pressure of over 100 certainly points to continuous hyper-tension. If the difference between the systolic and the diastolic is normal, about 30 to 40, we may conclude that the heart’s impulse is normal, and that even in conditions of marked sclerosis there is efficient compensation.