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On the other hand, if the diastolic is being raised by an increased venous pressure from a failing heart, digitalis, strychnin and caffein may be of benefit in lowering the diastolic as well as raising the systolic. However, if there is a high systolic and a low diastolic pressure, vasodilators are often contraindicated.

Five patients had a blood pressure of 140 or over throughout their pregnancy, and in only one of these patients was albumin found. All passed through labor normally, showing that a blood pressure below 150 may not necessarily be indicative of a serious condition; but a patient who has a systolic pressure over 135 must certainly be carefully watched.

On the other hand, a high systolic pressure without a high diastolic pressure should not be rapidly lowered, else depression will be caused. In hypertension, as long as the heart, which is probably hypertrophied, remains perfectly competent, there are few symptoms, and the person does not seek advice until he notices one or more of several possible conditions.

Sex in children makes no difference in the blood pressure, it being determined by the height and weight. Jour. Dis. The systolic pressure varied from 91 mm. in the fourth year to 105.5 in the fourteenth year, while the diastolic pressure remained almost at a uniform level. The pressure pulse, therefore, increased progressively with the increase of the systolic pressure.

If the heart muscle is intact, he finds such absorption in high pressure cases will show diastolic as well as systolic increase: The vessels pulsate and throb; the skin is pale; the head aches; the tongue is coated; the breath is foul; vertigo is often distressing; and not infrequently the hands and feet feel distended and swollen.

The succeeding heart beats after abortive beats or after a contraction of less power have increased force, and consequently give the highest blood pressure. Kilgore urges that these highest pressures should not be taken as the true systolic blood pressure, but the average of a series of these varying blood pressures.

The bottle of the gall subtracts from thence all the superfluous choler; whence it is brought to another shop or work-house to be yet better purified and fined, that is, the heart, which by its agitation of diastolic and systolic motions so neatly subtilizeth and inflames it, that in the right side ventricle it is brought to perfection, and through the veins is sent to all the members.

The strenuous measures that should he used to lower a high diastolic pressure are contraindicated when the diastolic pressure is already low, even if the systolic pressure 1s high. If a high systolic pressure begins to fall more or less rapidly the heart shows fatigue, and should be stimulated by digitalis or strophanthin.

These dangerous rises in venous pressure are generally coincident with a fall of systolic arterial pressure, although there may be no constant relation between the two. He also finds that with an increase of venous pressure the urinary output decreases. This, of course, shows venous stasis in the kidneys as well as a probable lowering of arterial pressure. Int.

Then reduce the pressure 5 mm. and read again for a minute, and so on down the scale until the varying systolic pressures are recorded. The average of these pressures should be read as the true systolic blood pressure.