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The observations that follow give some indication of the prevalence of the commoner cardiovascular diseases, including cerebrovascular accidents and the disability resulting therefrom, in a random sample of 476 elderly people living at home in Sheffield. They are based on full clinical examinations which were carried out in the subjects' homes.The importance of cardiovascular disease in the elderly needs no emphasis. It accounted for 42 per cent of all deaths of men over pensionable age (65+) and the same percentage of all deaths of women over pensionable age (60+) in England and Wales in 1949 (Int. List Nos. 90-103). If deaths from intracranial lesions of vascular origin (Tnt. List No. 83) are added, the figures become 54 and 58 per cent. Of the 476 subjects, 192 were men and 284 women. Eighty per cent of the men and 47 per cent of the women were over 70 years of age. DERIVATION OF SAMPLE In 1948, a social survey had been carried out by the Council of Social Service on a 1: 30 sample of all Sheffield people of pensionable age, (Greenlees and Adams, 1950). The sample had been selected by a random procedure from the food office register. The group of elderly people used in the medical survey was derived from this sample and included all those living alone or living alone with spouse who could be traced and agreed to be examined. Those living alone or alone with spouse were chosen to facilitate a dietary survey which was carried out at the same time. Of 736 possible subjects, 260 were not available when the medical survey came to be done. Sixty-four had died. Thirty-six were no longer living alone or alone with spouse, 18 had left Sheffield or could not be traced, and in 142 cases, consent for the examination was withheld. As two years had elapsed between the two surveys, the youngest women in the medical survey were 62 and youngest men 67. The sample included all social classes and we believe was reasonably representative of elderly people living independently at home. There was, however, a slightly higher proportion of women and of representatives of the higher income groups amongst the refusals. Ninety-four per cent of the medical examinations were carried out by one physician (H.D.). Sheldon (1948) appears to have been the only other investigator to have reported on a medical survey of old people in their homes. He interviewed 477 old people but did not carry out an examination of the cardiovascular system or measure the blood pressure. Gavey (1949) described the cardiovascular conditions found in 360 elderly people attending hospital for ophthalmic and other conditions including cardiac conditions. Neither of these surveys is strictly comparable with ours, the former, because similar investigations were not carried out, and the latter because the subjects were largely selected on account of sickness. Where possible, however, in the absence of more comparable material, we have compared the findings of these authors with our own. PREVIOUS SURVEYSIn a health survey which includes those who are not ill as well as ...

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1. Acetoacetic acid and its sodium salt administered by continuous intravenous infusion to rabbits produced a state resembling diabetic coma with normal or relatively high alkali reserves. 2. β‐hydroxybutyric acid did not produce coma even at low alkali reserves. 3. Hydrochloric acid with one exception produced coma only at low alkali reserves. 4. It is concluded that diabetic coma is due in the main to a specific intoxication by the acetoacetic anion. The authors desire to express their thanks to Professor E. J. Wayne at whose suggestion the work was undertaken, and to both him and Dr. H. A. Krebs for valuable advice and criticism: the latter also for the preparation of β‐hydroxybutyric and acetoacetic acid.

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