THE note on polycythaemia hypertonical in the Epitom-le of Current Medical Literature of October 25th, p. 14, induces me to tlhink the following case may be of interest: A man, aged 45, came to consult me regarding his high blood pressure. He had been under treatment for this condition for over two years, but his symptoms had increased in severity, and he was now subject to recurrent attaoks of vertigo, which rather alarmeli h-iim. 'J'he history was one of gradually increasing cyanosis during

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... e last eight years, some shortness of breath, aiid incoreasing. muscular weakness. About April 1918, some bombs which fell near his house during an air raia greatly upset him. Within twenty-four hours this was followed by swelling of the neck and thyrold 'gland, which became as large as two duck's eggs.. The swelling igradtial-, receded until it became the size -of a hen's egg and had remained in that oondition. From this time he became nervous and exhibited signs of hyperthyroidi §m. Dviring the last month he hatd had several attacks of giddiness with some confusion of mind, lasting a few seconds. There was no history of speolfic disease. HIis face showed a well-marked degree of cyanosis. The superficial temporal arteries were tortuous and thickened. The radial pulse felt hard and gave the impression of high tension. The artery was thickened. The blood pressure, takenon three separate occasions, was always about 120 mm. Hg.