considered. There is a call made on the contractibility of the small arteries on the one hand, and on the amount of muscular force of the heart on the other hand, and if the structures in question can not respond to this call, rupture of an artery or dilatation of the heart may ensue. In the case of a normal condition of the circulatory organs little harm is done beyond some transient discomfort, such as dizziness, buzzing in the ears, palpitation, general malaise, and this often only in the case of people totally unaccustomed to high altitudes. For such it is desirable to take the high altitude by degrees in two or three stages, say first stage 1,500 feet, second stage from 2,500 to 3,000 feet, and third stage from 4,000 to 6,000 feet, with a stay of one or two days at the intermediate places. The stay at the health resort will be shortened, it is true, but the patient will derive more benefit. On the return journey one short stay at one intermediate place will suffice. Even a fairly strong heart will not stand an overstrain in the first days spent at a high altitude. A Dutch lady, about forty years of age, who had spent a lifetime in the lowlands, came directly up to Adelboden (altitude, 4,600 feet). After two days she went on an excursion with a party up to an Alp 7,000 feet high, making the ascent quite slowly in four hours. Sudden heart syncope ensued, which lasted the best part of an hour, though I chanced to be near and could give assistance, which was urgently needed. The patient recovered, but derived no benefit from a fortnight's stay, and had to return to the low ground the worse for her trip and her inconsiderate enterprise. Rapid ascents to a high altitude are very injurious to patients with arterio-sclerosis, and the mountain railways up to seven thousand and ten thousand feet are positively dangerous to an unsuspecting public, for many persons between the ages of fifty-five and seventy years consider themselves to be hale and healthy, and are quite unconscious of having advanced arterio-sclerosis and perchance contracted kidney. An American gentleman, aged fifty-eight years, was under my care for slight symptoms of angina pectoris, pointing to sclerosis of the coronary arteries. A two-months' course of treatment at Zurich with massage, baths, and proper exercise and diet did away with all the symptoms. I saw him by chance some months later. 'My son is going to St. Moritz (six thousand feet) for the summer,' said he; 'may I go with him?' 'Most certainly not,' was my answer. The patient then consulted a professor, who allowed him to go. Circumstances, however, took him for the summer to Sachseln, which is situated at an altitude of only two thousand feet, and he spent a good summer. But he must needs go up the Pilatus by rail (seven thousand feet), relying on the professor's permission, and the result was disastrous, for he almost died from a violent attack of angina pectoris on the night of his return from the Pilatus, and vowed on his return to Zurich to keep under three thousand feet in future. I may here mention that bad results in the shape of heart collapse, angina pectoris, cardiac asthma, and last, not least, apoplexy, often occur only on the return to the lowlands."
The Parliamentary Amenities Committee.—Under the above rather misleading title there was formed last year, in the English Parliament, a committee for the purpose of promoting concerted action in the preservation and protection of landmarks of general public interest, historic buildings, famous battlefields, and portions of landscape of unusual scenic beauty or geological conformation, and also for the protection from entire extinction of the various animals and even plants which the spread of civilization is gradually pushing to the wall. In reality, it is an official society for the preservation of those things among the works of past man and Nature which, owing to their lack of direct money value, are in danger of destruction in this intensely commercial age. Despite the comparative newness of the American civilization, there are already many relics belonging to the history of our republic whose preservation is very desirable, as well as very doubtful, if some such public-spirited committee does not take the matter in hand; and, as regards the remains of the original Americans, in which the country abounds, the necessity is still more immediate. The official care of Nature's own curiosities is equally needed, as witness the way in
