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 appreciated amongst the profession as they deserve to be, while it is often by no means easy to make patients understand its aims and intentions, or submit to the restrictions which it involves. Of course, the principle has to be carried out in different degrees, according to circumstances; but this point I cannot now discuss. Not only does it apply to physical rest, but also to freedom from mental disturbances of all kinds, which are such important factors in a large number of instances. The fashionable modern fad, known as the "rest cure," is certainly as much applicable to cardiac as to any other kind of case, and may be of decided help when carried out rationally and intelligently.

4. The direct withdrawal of blood, whether by venesection or by local methods, especially leeching and cupping, is a measure which has from time immemorial been recognised as having very definite and important effects upon the heart and vessels, the circulation, and the blood, and no doubt it influences more or less certain pathological processes. Speaking personally, I can well remember the time when these methods were practised as a matter of routine in a most absurd and dangerous manner. Then a reaction took place, when they were to all intents and purposes discarded, and fell into disuse. More recently they have again been revived, but on more rational lines, and no doubt they can under certain circumstances be employed