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general similarity between the renal effects of aminometradine and of mersalyl suggests that the same mechanism of "resistance" might apply to both drugs. As shown in these results, the increase of chloride excretion exceeded that of sodium after mersalyl but was slightly less than the increase of sodium excretion in the case of aminometradine. This will lessen somewhat the liability of aminometradine to reduce the plasma chloride concentration and also render the development of " resistance" to this drug less probable. Although the effect of mersalyl was greater than that of aminometradine during the first 24 hours after administration of either drug, the urine flow during the second 24 hours was frequently greater after aminometradine. Thus the net effect of the two drugs when they were administered at intervals of 48 hours was comparable. The more sustained and less violent diuresis caused by aminometradine given every 24 or 48 hours, as compared with that produced by mercurial diuretics, which are usually administered two or three times weekly, may be advantageous in some patients with heart failure. The observations that the maximum diuresis from aminometradine often does not develop until the third or fourth day of administration, and that the diuresis caused by a single dose lasts more than 24 hours, suggests that a single dose of 400 mg. is not completely excreted in 24 hours. It is therefore probably advisable not to administer the drug daily but to allow one or two days of freedom from treatment each week. It is possible that the main use of aminometradine may be found in the prophylaxis of oedema in those patients with chronically recurring cardiac failure who constantly require a diuretic. As pointed out by Spencer and Lloyd-Thomas (1953), assessment of the diuretic action of any drug in the treatment of heart failure is fraught with difficulty, owing largely to the tendency of the patients' clinical condition to fluctuate spontaneously, and this applies particularly to the prophylaxis of cardiac oedema. The evidence accumulated so far suggests, however, that a clinical trial of the prophylactic effect of aminometradine would be worth undertaking. Summary

Shigellosis in the First Two Years of Life