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142 very thick. Of the neurasthenics 92 per cent. had palpable radials, and in 8 per cent. the artery could not be felt. In 40 per cent. the artery was much thickened. In the majority of the men there was no obvious difference between the arteries on the two sides. Of 87 soldiers with palpable radials 48 had some infectious disease since childhood, and 40 were under the age of 26 years. The artery was markedly palpable in healthy soldiers of 18, 19, and 22 years. In only three men was there a history of alcoholism, and these had palpable radials. In 25 healthy soldiers under the age of 22 years it did not seem that heavy work could have been responsible for the palpable radials. It has been stated that spasm or hypertonus may render the radial artery temporarily palpable, but it was difficult to believe that hyper- tonus could be the cause in so many men. In three cases an endeavour was made to eliminate spasm by immersing the forearm in water as hot as could be borne, but the radials remained just as palpable. They were more frequently and more markedly palpable in the neurasthenics, especially in those whose symptoms were of long standing. The systolic blood pressure (taken with Lauder Brunton’s sphygmometer) in healthy soldiers was about 130--0. The pressure differed little in those whose arteries were markedly palpable, just palpable, or not palpable. The pressure did not vary with the palpability of the artery, or at all constantly with age. THE HISTORY OF HUMAN DISSECTION. IN his first professorial lecture 1 at Lyons Dr. A. Latarjet told the history of anatomical investigation, paying eloquent tribute to his master, Testut, whom he succeeds in the chair of anatomy. The student of to-day is so much engaged in gathering in the latest views, that he can spare few moments to listen to the echo of the voices of the past. ’Tis true, ’tis pity, and we must make the best of it, but the students of Lyons should be grateful for the glimpse given them of the great antiquity of the science they study. Prof. Latarjet distinguished three great periods in anatomy : his first period extending from remote times to the downfall of the Western Roman Empire ; -, his second, including Harvey, from the thirteenth to the seventeenth centuries, a period marked by increasing perfection in knowledge of detail, technique, and application of experimentation ; the third, the age of evolution, of scientific grouping and blending of biological sciences, of study of human races with the wider application of anatomy to clinical and pathological conditions. The large part played by France in the two later periods was naturally and justly insisted upon. England, which scarcely entered the world of medicine before the thirteenth cantury, may herself claim a preponderating share in the same periods, although we fear that many of the names of the men who wrought so well are unknown to present-day students. Harvey-" Your Anatomist," as he styles himself in addressing his College-occupies a position which is unique. Judging his work by its results, it has had more influence on medicine, in the large sense, than any other : it swung the ship round on a different course. Had Galen, writing on the heart valves described by Erasistratus, but seen the truth by intuition, it is impossible to imagine what the science of medicine might have been like to-day. Harvey, howev er, was not the first anatomist to use experimental methods, although Prof. Latarjet appears to suggest this when he assigns such " new methods " to the time of Harvey, Aselli, and Pecquet. Galen would still rank to-day among leading exponents of experimental physiology by his boldness, clearness, and judgment, but his preconceptions closed his eyes to much that - was before him ; like us he only saw that which he was prepared to see. It was owing to Galen’s experi- mental work on dogs and swine that his anatomical views of the human subject were mingled with those 1 Paris Médical, Nov. 26th, 1921. properly belonging to the structure of such animals, but we doubt whether Prof. Latarjet is justified in denying that Galen or others of his age practised human dissection. Le Clere holds the reasonable opinion that Galen certainly, if only occasionally, dissected the human body. The remark of Seneca about physicians opening bodies to ascertain cause of death, and the record of Hesychius that " Hermo- genes, the rhetorician, having died was dissected," are in proof of human dissection in ancient times. Nor is there any special reason for thinking that the opportunities open to Herophilus in the early Ptolemaic time became obnoxious to the later Ptolemaic spirit. When this line came to an end, however, and Egypt became a Roman province, no doubt popular feeling as well as Roman law went, against the practice. Hence the difficulties which Galen had to surmount, as is apparent from his writings. In Arabian medicine there was no practice of dissec- tion. It was occasionally undertaken at Byzantium, where the Eastern Empire still lingered gorgeously, but the religious forces were strongly against its recognition, and it was probably only performed in secret. During the pre-Renaissance period swine were in extensive use for anatomical teaching, and even as late as the sixteenth century we know that Berengarius. gave his first anatomical demonstration on the body of a hog in the house of Albertus Pius. Religious obstruction was potent before the days of the more liberally-minded Popes ; yet it is hard to believe that the wider views of the Benedictines, for example, which led them to foster the growth of the school of Salernum, did not at the same time show them the necessity of studying the structure of man-the subject of the science of medicine, as old Mondinus has it. The same Mondinus, writing in the fourteenth century, gives the first manual for human dissection, referring on occasion to the pig by way of contrast. There are hidden rooms in some of the old universities said to have been used for human dissection, and recent research suggests that certain malefactors were handed over alive for this purpose during the fifteenth century. It may, in fact, be said that human dissection was practised from the thirteenth century, when the law of Frederick II., regulating the training of medical men (1213), insisted on a course of human anatomy and provided for the same. Ever since dissection has been a recognised road to knowledge. PRIMARY TUBERCULOUS PERICARDITIS. ALTHOUGH some authorities have categorically denied the occurrence of a primary isolated tubercu- lous pericarditis, apart from glandular or other lesions, from time to time cases are reported in which a clinically primary pericarditis has been established post mortem, being found to be associated with no other discoverable trace of tuberculosis elsewhere. In a paper recently published, Dr. Carl A. I3edblom, i after briefly abstracting eight such cases reported in the literature since 1897, gives details of a case per- sonally observed at the Mayo Clinic. In this patient, a man of 36, the clinical diagnosis was based on the chronicity, the recurrence of effusion after repeated aspiration, the history of recent exposure to tubercu- lous infection, and the absence of any other recognis- able disease. Pericardiotomy was performed under local anaesthesia, partly in the hope that an open operation might prove curative on the analogy of a simple laparotomy in tuberculous peritonitis, and 2000 c.cm. of sero-purulent fluid were evacuated. Although guinea-pig inoculation of the exudate gave a negative result, a section of the pericardium, examined microscopically, showed unmistakable tuberculosis. Immediate relief was obtained from the operation, but there was a recurrence of the effusion, and six weeks later pericardiotomy was again performed, and a similar quantity of fluid evacuated. Convalescence from this second operation was com- plicated by thrombo-phlebitis of the right jugular 1 The Surgical Clinics of North America, October, 1921.
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