SPHYGMOMANOMETER AND ENDOCRINES 137 
In the minds of the laity and, for that matter, with a 
large number of physicians, high blood pressure is the 
only thing to be watched for, without realizing that a 
hypotension for the age average, or a steadily falling 
pressure of the blood, indicates an atonic state, a 
toxemia, a concealed hemorrhage or some other grave 
condition. They are also ignorant of the fact that 
hypotension is of more common occurrence than hyper- 
tension. 
BLOOD PRESSURE IN ACUTE INFECTIOUS DISEASES 
If we make a comparative study of the findings 
accompanying acute infectious diseases, we find some 
characteristics common to all, others common to many, 
and were it not for the uncommon characteristics, we 
could not distinguish many of these diseases from one 
another. For instance, recall how many acute infec- 
tions begin with a chill, followed by a fever, with the 
rise and fall of temperature peculiar to the particular 
disease. 
In most infections and also in most chronic condi- 
tions (with a few exceptions which I will mention 
later), we find an arterial hypotension. Usually, with 
the onset of fever in acute infections, goes a temporary 
rise of blood pressure. In some instances of infection 
when I was called during the chill and had my sphyg- 
momanometer with me, I have found the pressure to 
be rising even then. Undoubtedly if we could be able 
to secure reading more frequently at this stage, we 
should find the blood pressure changes of much interest 
and practical value. 
While the fever may keep up for days, within two or 
three days after its onset, the blood pressure begins to 
fall and continues to do this until it reaches a point 
considerably below the normal for the patient’s age. 
As an exception in infectious diseases, might be men- 
tioned meningitis, in which hypertension is more often 
