ANGINA PECTORIS, a term applied to a violent paroxysm of pain, arising almost invariably from disease of the coronary arteries with consequent degeneration of the heart muscle (see HEART, DISEASES OF). An attack of angina pectoris usually con sists in a sudden agonizing pain, felt at first over the heart, but radiating through the chest in various directions, and frequently extending down the left arm. A feeling of constriction and of suffocation accompanies the pain, although there is seldom actual difficulty in breathing. When the attack comes on, as it often does, during bodily exertion, the sufferer is at once brought to rest. The countenance becomes pale, the surface of the body cold, the pulse feeble, and death appears to be imminent, when suddenly the attack subsides and complete relief is obtained. The duration of a paroxysm rarely exceeds two or three minutes, but it may last longer. The attacks are apt to recur on slight exertion, and in aggravated cases without any such exciting cause. Occa sionally the first seizure proves fatal. Angina pectoris is extremely rare under middle life, and is much more common in males than in females. In the treatment of the paroxysm, nitrite of amyl has now replaced all other remedies. It can be carried by the patient in the form of nitrite of amyl pearls, each pearl containing the dose prescribed by the physician. As soon as the pain begins the patient crushes a pearl in his handkerchief and holds it to his mouth and nose. The relief given in this way is marvellous and usually takes place within a very few seconds. To prevent recur rence of the attacks something may be done by administration of nitroglycerine, scrupulous attention to the general health and the avoidance of mental and physical strain.