certain characters of the impulse; as well as in studying abnormal arterial pulsation. As already mentioned, there seems to be no doubt that Harvey was acquainted with, and probably practised, direct auscultation in the examination of this organ. I take advantage of this fact to emphasise the essential help in diagnosis afforded by this simple method, without the aid of any instrument or apparatus, under a variety of circumstances, when applied to the heart and large arteries. It may be noted in passing that auscultatory-percussion has been advocated as a help to determine the size of the heart. The phonendoscope is a comparatively modern instrument which has been much vaunted for the examination of this organ, but certainly discretion should be exercised in its employment, else serious errors may arise from mere exaggeration of sounds. Another application of this apparatus, with the aid of a small brush, has been introduced for the purpose of marking out the exact dimensions of the heart and thus determining its functional capacity, but I have no personal knowledge of the practical results of this procedure. How far the more modern special methods or instruments for demonstrating or recording the cardiac movements, especially the cardiograph, may be clinically helpful in particular cases must be left to individual judgment, but their application in the ordinary run of practice can only be decidedly limited.
