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effusion independently of medicine tends to lessen and disappear. It would almost seem that this hypertrophy, whether of the heart or arteries or both together, is the natural cure for the dropsical state. This at first sight is difficult to reconcile with the early increase of dropsy, together with increasing arterial tension; for now with advancing hypertrophy the tension becomes greater but the dropsy less. The hypertrophy is little of the right ventricle, mainly of the left ventricle and the arteries, and appears to militate against the dropsy so long as the cardiac charge is unaccompanied by dilatation. Whether the heart or arteries have the more to do with this mitigation must be taken into question. The arterial thickening cannot fail, so far as I see, to obstruct the access of blood to the capillaries and dam it back in the heart and larger vessels, with the result of increased tension and increased cardiac hyper- trophy. Here comes in the stopcock action, and with it lessened capillary pressure and lessened exudation. Now let us glance for a
