SOME PRESENT-DAY CONCEPTS OF THE SYMPTOMS
Two Groups of Symptoms.
—With the increasing evidence1 for the view2 that essential arterial hypertension occurs first and organic changes in the arterioles are a sequence, there has developed the belief that these apparently successive pathologic states are accompanied by separate groups of symptoms. These may be termed the early and the late group of symptoms, the former being associated with the stage of pure arterial hypertension and the latter developing as a result of the vascular changes. Rolleston expressed the belief that the early and late symptoms, which differ in character, differ also in etiology.3 It is important, therefore, for prognosis and study to distinguish between the so-called early and late symptoms. Sir Clifford Allbutt recognized this distinction, for, in his discussion of the symptom of dyspnea, he said that it "is a very late symptom. We are in the fifth act."4 Of
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