circulation and increased tissue change, and thereby insure healing . For this reason a blister is placed upon the callous ulcer, which heals with the fresh may cause its owner's death by its inability to carry on the circulation against increased - resistance. This may occur suddenly, as when the resistance is increased in the arterial system by a e on f sudden exertion or strain, and more slowly when the resistance is increased in the pulmonary circulation of the by inflammation of the respiratory passages. The thyroid gland, which is situated in front of the neck, yields a secretion which passes into the blood and there tends to maintain a state of moderate dilatation in the blood-vessels and of oxidization in the tissues, so that the circulation remains good and the body-heat and muscular activity remain well maintained. Blisters also cause local dilatation of vessels, but are usually applied to the skin for inflammation in deep-seated parts, such as the lungs, though they also relieve pain in the joints in acute rheumatism. Bier increases the blood in a part by compressing the veins and thus producing passive instead of active congestion. The toxins produced by microbes, if too weak to destroy the leucocytes, induce them to secrete antitoxins, which not only act as antidotes to the toxins and are injurious to the microbes, but also increase the phagocytic power of the leucocytes (opsonius of Wright). Where the surface is ulcerated it may be protected from external violence and placed under favourable conditions for healing by covering it with lint moistened with water and with oil-silk over it to prevent evaporation. If the granulations tend to This latter cause is chiefly observed when the tissues are of a very unyielding character; for example, when the inflammation occurs in a bone or under a thick fibrous and unyielding membrane. The swelling, heat and pain may sometimes be relieved by mere change of position altering the flow of blood to the inflamed part. Thus when inflammation occurs in the finger, as in a whitlow, the pain is not only constantly severe, but it is increased by every pulsation of the heart, and thus has a throbbing character. Although the high temperature in an inflamed part is chiefly due to the increased circulation of blood in it, yet the presence of inflammation appears to cause increased formation of heat either in the inflamed part itself or in the body generally, because we rarely find inflammation exist to any extent without the temperature of the body being raised and a febrile condition produced. Two very old remedies for fever are acetate of ammonia and nitrous ether. These were formerly given empirically, simply because they had been found to do good. Before death occurs the pulse and respiration become exceedingly rapid and weak, and complete unconsciousness sets in. That these symptoms are simply due to heat is shown by the fact that if the temperature be quickly reduced by the application of cold the symptoms at once subside. But the delirium which is common in fever, although it may be partly due to rise of temperature, is very often due to poisons in the blood, for in some cases it occurs with quite a low temperature, 101° or 102°, whereas in others the temperature rises to 104° and 105° with no delirium whatever. At the same time other symptoms, such as exophthalmos, may appear, which have an independent origin and are not due to the secretion of the gland. The whole of the secretion here is poured into the blood and not at all on to a mucous surface, and herein the thyroid gland differs largely from such glands as the pancreas or peptic and intestinal glands. It is known that several, perhaps very many, if not all glands have also the power of secreting substances to which Starling has given the name of "hormones." These pass into the blood and cause other glands to secrete. Thus an acid in the duodenum causes it to secrete a hormone to which the name of "secretin" has been given. This passes to the pancreas and causes increased secretion from that gland. It is probable that the pancreas in its turn also secretes something which activates a ferment in the muscles. We have also considered in a general way the treatment of local diseases by passive protection, active protection and repair of waste; but both maintenance of health and repair of waste depend very largely upon the condition of the blood. When this is healthy the attacks of microbes are resisted, wounds heal readily, and patients recover from serious diseases which in persons of debilitated constitution would prove fatal. In order to keep the blood in a satisfactory condition it must be well supplied with fresh nutriment, and the products Nutrition and elimination of waste freely eliminated. The food required for the body may be divided into five kinds - carbo- nation. A combination of the two kinds of remedy is sometimes useful, and chloral sometimes succeeds when other things fail, because it depresses the circulation as well as lessens the activity of the brain-cells. Irritation of sensory nerves tends to cause contraction of the vessels, and to raise the blood pressure, and where pain is present Pain. opium or morphine is the most efficient sedative. The sensation of pain is felt in the brain, and the cause of it may be in the sensory centres of the brain alone, as in cases of hysterical pain, with no lesion to cause it. Both sleeplessness and pain are sometimes due to the action of toxins absorbed from the intestine, and both of them may High tension. sometimes be relieved more efficiently by thorough purgation than by narcotics. Another condition which is probably due to toxins is high pressure within the arteries. When this continues for a length of time it tends by itself to cause deterioration of the blood-vessels and leads to death either by cerebral apoplexy or by cardiac failure. It is therefore very important to discover high tension at an early period.