DR. Benjamin M. Goldstein, Chief Resident in Medicine, the Jewish Hospital of St. Louis, and Instructor in Medicine, Washington University School of Medicine: A 33-year-old white married woman was admitted to Jewish Hospital in March 1967 for evaluation of hypertension. The patient was first found to be hypertensive in 1966. She had been normotensive during a previous hospitalization for pneumonia in 1965, but a highpitched abdominal bruit was heard at that time. The patient had three pregnancies, none of which were complicated by hypertension. She had also been taking (Ovulen) for four years prior to her admission to Jewish Hospital. There was no history of renal disease nor family history of hypertension. Her only complaints on admission were those secondary to anxiety and tension.
Physical examination revealed a healthy appearing white woman. Blood pressure was 210/120 mm Hg and remained at about this level throughout her preoperative course. The pulse