272 ON DIAGNOSIS IN ANEURISM OF THE AORTA, & C. 
gin ; its tunics likewise thin in several places, though in others 
much contracted in caliber, and of a knotty appearance. From 
these appearances it seems that this mare not only suffered from 
aneurism of the anterior mesenteric, but likewise from the same 
affection in the posterior and its ramifications. The thickening of 
the coats, the diminished elasticity and contraction, as well as the 
knotty appearance, shewed that this was the result of inflammation 
with which the aneurism had been complicated. 
From the experience of conclusive observations of these four 
cases, Herr Rohling draws the following conclusion : — Aneurism 
of the large arteries, in any of the cavities, particularly the aorta 
or the mesenteric, may be ascertained by certain signs, through 
which a sure diagnosis might be established. The surest of these 
signs is the 'pulsation at the parts. This is caused by an obstruc- 
tion of the circulation in the aorta, and by the formation of a 
thrombus, which is the result of inflammation not only in the ante- 
rior mesenteric artery, but also in the aorta. Besides this pulsa- 
tion at the back, there is another symptom which is equally of 
great importance, and this is the slow pulse. It is true that in 
Case II there was an increased pulse; but the three other cases 
were particularly distinguished by the slowness of the pulse. It 
must also be taken into account that the second case was very 
acute, was accompanied by strong fever, which was by no means 
the case with the other three. Taking for granted that a slow 
pulse arises from a deficiency of nervous influence on the vascular 
system, it is equally an acknowledged fact, from long experience, 
that an intermittent pulse arises from vascular obstruction in the 
intestinal vessels. This seems confirmed by the last case, in which 
an intermittent pulse was observed, which certainly could not have 
its origin in the nerves of the bloodvessels ; therefore the question 
arises, was not this intermittence of the pulse in the last case analo- 
gous to the slow pulse in the other cases, particularly when a fe.w 
slow beats were found to be followed by a quicker or even in- 
creased pulsation I Herr Rohling leaves it to those who are more 
versed in these matters to decide this point ; and at the same time 
begs to remark, he recollects many cases, in his long practice, which 
lead him to suppose that the slow pulse does not always arise from 
want of nervous influence, but may also proceed from disease of the 
bloodvessels ; and the Cases I, III, and IV, go far to confirm this 
opinion. As to the etiology of the aneurism of the mesenteric 
artery in these four cases, in none of them could it be traced to any 
particular cause. All the subjects were employed in a more or 
less quick service ; but no one was hard worked. 
Magazin fur die Gesammte Thierheilkunde , Berlin 1849. 
