During the past three years mitral valve disease has been studied intensively at the Institute of Cardiology and at the Cardiac Department of the Brompton Hospital. It is the purpose of this paper to present a comprehensive review of the facts ascertained during this period. The work represents an elaboration of one of the papers opening the discussion on mitral stenosis at the European Congress of Cardiology held in London on September 9 to 12, 1952, and summarized in the Abstracts of Scientific Communications.

The normal pulmonary blood pressure in a series of 60 normal controls studied at the Institute of Cardiology and at the Brompton hospital was 16/7 mm. Hg with reference to the sternal angle, the mean being 11 mm. and the range 8/2-28/14 mm. The mean cardiac output was 8 litres a minute, and the common range 5 5 to 10-5 litres a minute. The left atrial pressure averaged 2 to 3 mm. Hg.The pulmonary vascular resistance, which in simple units is the pulmonary artery pressure minus the left atrial pressure in mm. Hg divided by the pulmonary blood flow in litres a minute, was therefore about 1 unit or 80 dynes sec./cm.-5.Definition of Pulmonary Hypertension. Pulmonary hypertension literally implies a pulmonary blood pressure above 30/15 mm. which is the upper limit of the normal range. In practice serious pulmonary hypertension usually means a pressure at or around systemic level, but rarely in excess of 150 mm. CLASSIFICATIONThere are five basic types of pulmonary hypertension as shown in the classification below, and it may help to add a sixth (polygenic), to describe cases of mixed aetiology.

Acute Head Injury. By JOSEPH P. EVANS edition will soon be needed for such a sound and T~~~ small monograph of just over a hundred pages gives authoritative exposition of such an important subject. a concise description of the diagnosis and treatment of The chapter on injuries to the heart might also, with acute head injuries.is divided into four definite advantage, be made somewhat fuller. l'he principles parts : scalp injuries, skull fractures, meningeal haemor-and results of surgical treatment of arteriovenous rhaae in its various forms. and cerebral trauma.?neurysm shquld also be more accurately and criticallyAs the incidence of head iniurv in this mechanical age described and presented.is so high, it behoves the profeskon to understand tge rational principles of treatment of acute cranial and intracranial injury. This little monograph goes a long way to provide a lucid description of the treatment required for such injuries.

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