Les maladies du coeur et la circulation dans l'enfance et l'adolescence . iblepulse, marqué de la sorte dans cette maladie. Le pouls est soudain andbounding, donnant une impression d'apparente force, mais elle iselevated soudainement, et tombe immédiatement. Dans les mots, le ofCorrigan les troncs artériels de la tête, du cou, et upperlimbs à la fois attirer l'oeil par leurs propres pulsations ; ateach la diastole, sous-clavière, carotide, temporelle, andsometimes humérale même les artères palmaire sont projetés de force depuis 126 Keating et Edwards : Les maladies du Cœur leur lit et tenu sous la peau. Afin de mieux l'ob-serv

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Diseases of the heart and circulation in infancy and adolescence . iblepulse, so marked in this disease. The pulse is sudden andbounding, giving an impression of seeming strength, but it iselevated suddenly, and falls immediately. In the words ofCorrigan, the arterial trunks of the head, neck, and upperlimbs at once attract the eye by their peculiar pulsations; ateach diastole the subclavian, carotid, temporal, humeral, andsometimes even the palmar arteries are projected forcibly from 126 Keating and Edwards : Diseases of the Heart their bed and bound under the skin. In order to better ob-serve these points we are in the habit of having the patientstrip one arm and preferably one side of the chest, separatingthe arm from the body, serniflexing and supinating the fore-arm ; the observer at a glance will be able to note the entirecourse of the arteries under consideration. The character of this pulsation is well shown by the cardio-graph tracing upon a case, set. seventeen, with aortic insuffi-ciency. Corrigans original explanation, which has stood the. (From Paul.) test of years, cannot be improved upon : When the semi-lunar valves are healthy they are closed by the pressure ofblood immediately after each ventricular contraction. Whenthe occlusion is complete the blood propelled from the ven-tricle is retained in the aorta, and the large vessels remaindistended. These vessels then maintain almost the samecalibre in systole as in diastole. But when the valves nolonger close the aortic orifice, a certain amount of blood flowsback into the ventricle after each systole; it follows that theascending aorta and the arteries supplied by it allow a certainamount of the blood contained in them to escape; they be-come flaccid after each ventricular contraction and their diam-eter diminishes. At this moment a fresh contraction of theventricle rapidly forces into the vessels a quantity of bloodwhich dilates them forcibly and suddenly. The arterial dias-tole is then marked by such

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