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White found that about half of his cases of pulsus alternans showed an increased blood pressure of 160 mm. or more; 62 percent. were in patients over 50 years of age, and 69 percent. were in men. Necropsics on patients who died of this condition showed coronary sclerosis and arteriosclerotic kidneys.
The onset of dyspnea, with a rapid pulse, should lead one to suspect pulsus alternans when such a condition occurs in a person over 50 with cardiovascular-renal disease, arid with signs of decompensation, and also when such a condition occurs with a patient who has a history of angina pectoris.
Pulsus alternans, except when it is very temporary, Gordinier finds to be of grave import, as it shows myocardial degeneration, and most patients will die from cardiac insufficiency in less than three years from the onset of the disturbance.
Monoceros Blainvillii, d'Orbigny "Voyage" Pal. 2. Monoceros ambiguus, G.B. Sowerby. 3. Anomia alternans, G.B. Sowerby. 4. Pecten rudis, G.B. Sowerby. 5. Perna Gaudichaudi, d'Orbigny "Voyage" Pal. 6. Ostrea, small species, in imperfect state; it appeared to me like a small kind now living in, but very rare in the bay. 8. Mytilus Chiloensis; Mr.
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