Page:The Harveian oration 1905.djvu/93

 3. To "feel the pulse" at the wrist has from time immemorial been a routine practice in the examination of a patient. What was to be learnt from the procedure must, however, to say the least, have been but very imperfectly understood in the past. Conspicuous progress has been made in the methodical study of the phenomena which examination of the arteries reveals, and of the conditions which they severally indicate, both as regards the circulation and the changes affecting the walls of these vessels. In an ordinary way these phenomena can be observed and appreciated by careful inspection, and the application of the fingers over the artery under investigation, usually the radial. Now-a-days, however, there is a manifest tendency in many quarters to advocate the routine employment for clinical purposes of certain of the scientific instruments and apparatus already referred to, and claims have been made as to their essential need for diagnosis, which personally I cannot admit. Of course, the sphygmograph gives valuable information not uncommonly, especially as regards certain details, and it is particularly useful when a permanent record is required. When, however, it is affirmed by eminent authorities, for whose opinion I have the highest respect, that no reliance can be placed on merely feeling the pulse for appreciating and estimating arterial tension and blood-pressure, and that some special apparatus for the purpose, of which several have been invented,