Page:The Harveian oration 1905.djvu/95

 Aneurysm, of course, has its own special signs, wherever it may happen to be situated. The brachial artery at the bend of the elbow is very convenient for studying the general condition of the arterial system, which is also frequently revealed by the temporal arteries. The observation of the venous pulse, especially in the jugular veins of the neck, is now a well-recognised part of the clinical investigation of the circulatory system, and needs only a passing mention. For studying the movements of the heart, as regards the relation of the auricular and ventricular systole, Dr. James Mackenzie employs an apparatus connected with a sphygmograph, by means of which simultaneous tracings of the radial and jugular pulses are taken. It must not be forgotten that auscultation reveals in certain conditions important signs in connection with arteries and veins, quite apart from aneurysm.

4. The use of the Röntgen rays, or Radiography, in relation to the heart and vessels, has already been referred to, and it will suffice to note here that this modern method of investigation is now definitely recognised clinically, and may be of real service in the positive diagnosis of certain cardiac and pericardial diseases, as well as of aneurysm. It may also be useful in demonstrating more definitely and accurately the actual morbid conditions present. Its results are up to the present not always reliable, however; and radiography is by no means so in-