Ten and a half years ago I saw in consultation a lady of 62 years of age. Blood pressure, 195 mm.Hg. She had obvious shortness of breath, even when lying in bed. The heart was considerably enlarged, the rhythm tick-tack. She had persistent headaches and there was a mild grade of cyanosis. The vessels were degenerate, and she was sleepless and depressed. As onerous duties devolved on her, I was pressed by the relatives for a definite opinion on the outlook. I gave it as an opinion that, at the rate she was deteriorating, the chances were that she would not survive for more that a year. That was in 1909, and I still have the pleasure of seeing her now in 1921.