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December 2, 1911


Author Affiliations


JAMA. 1911;LVII(23):1829-1832. doi:10.1001/jama.1911.04260120019007

It is with the treatment of chronic hypertension as with that of glycosuria or fever, or even pain; it should not, per se, be treated away, not artificially kept down,but watched as a valuable sign of most complex disturbances, of which we may or may not alter or eradicate the causes. Verily, to reduce hypertension is not its treatment; to maintain it will often be our task, as in cerebral arteriosclerosis and initial interstitial nephritis, in which increased blood-pressure is indispensable, and in which efforts to reduce tension would only aggravate the condition. In fact, there is in all pathologic hypertension a limit of irreducible tension which is above normal, but below which interference would disturb the cardiovascular equilibrium. To be guided by our nil nocere is a matter not only of academic dignity but of the most, practical value. Too often are misery and discomfort added to existing derangement

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