ABSTRACTS 305

(4) A fall in the average of the ten readings at successive visits should be demonstrable after a period allowed for the full effect of the treatment, and this effect should be maintained at two or more further observations. The patient should be under treatment for four to six weeks.

(5) The treatment shall then be omitted and a rise in blood pressure shown after ample time has been allowed for the effect of the procedure to have abated.

(6) Finally, a second hypertensive effect of the treatment should again be demonstrable.

Stieglitz, Edward J.: Bismuth Subnitrate in the Treatment of Arterial Hyper- tension. J. A. M. A. 95: 842, 1930.

The author proposes the use of bismuth subnitrate in the treatment of arterial hypertension. He has observed the results obtained in two hundred unselected cases of hypertensive arterial disease and one hundred and twenty cases of hypertension in pregnancy and believes the results are satisfactory. The action of the drug is due to the fact that it is sparingly soluble in the intestinal tract, small amounts of nitrate ions being liberated continuously which on conversion into nitrous oxide by Bacillus cob leads to gradual vasorelaxation.

Weiss, Soma, and Ellis, Laurence B.: The Rational Treatment of Arterial Hyper- tension. J. A. M. A. 95: 846, 1930.

The authors believe that in a small proportion of cases the blood pressure will return to normal and the symptoms will disappear either permanently or for a prolonged period of time following the institution of approved methods. Such remission in the case of arterial hypertension may, however, occur spontaneously, and these individuals should live well-regulated lives and be followed carefully. In the second group, there will be some lowering of the blood pressure, although not to a normal level with accompanying subjective improvement, and some checking of the progress of the disease. A third and larger group of patients will show no material lowering of the blood pressure, but their symptoms will be lessened, and they will be enabled to live more comfortable lives. In certain of these by the careful regulation of their mode of living acute cardiovascular accidents mill be averted, and to that extent their lives will be prolonged. The remainder, in par- ticular many of the cases of malignant hypertension, will progress inexorably, ap- parently uninfluenced by therapy, to a fatal termination.