ARTERIOSCLEROSIS IN ITS RELATION TO LIFE INSURANCE The value of the early recognition of cases of arteriosclerosis and hypertension has been spoken of within, but it needs to be further emphasized. There is perhaps no class among physicians to whom is afforded a better opportunity of seeing early cases than the medical examiners of life insurance companies. The relationship between a patient and the physician whom he consults, and the applicant for life insurance and the examiner are diametrically opposite. In the former the patient desires to conceal nothing and the physician is called upon to diagnose and treat disease. In the latter the applicant, a presumably healthy person, may have much to conceal and the examiner is there to pass upon the state of health. The question is this--"Is the applicant now in good health?" It becomes then of vital importance for the examiner to be able to detect among other abnormal conditions the incipient signs of arteriosclerosis and of hypertension. Parenthetically it may be stated that arteriosclerosis and hypertension are not one and the same disease as has been so frequently insisted upon within; the former may occur without the latter but the latter can not from its very nature be present for long without arterial thickening supervening. It is necessary in discussing the question here to group the two conditions together in order to prevent needless repetition. Such a case as the following is common. A successful business man of forty-four years was brought to me by an agent in 1905 for examination. The man was six feet tall, weighed 218 pounds, had a ruddy color and looked to be the picture of health. He was not strictly intemperate, he never became intoxicated, but every day he drank three or four whiskies and often he had a bottle of wine for dinner in the evening. When he was examined his pulse was of good quality and owing to the fleshiness of the wrist it was difficult to say positively whether the radial artery was sclerosed or not. In the heart no murmurs were heard, and it was difficult to be sure that the left ventricle was enlarged. There was, however, a slight but definite accentuation of the second sound at the aortic cartilage which might readily have been overlooked had the patient not been stripped and a careful examination made with the stethoscope. Upon taking the blood pressure it was found to be from 170-175 mm. of Hg. The urine specimen examined at the visit was normal, no casts were found. The applicant was seen at his home and the blood pressure measured. It was again the same. He was seen a third time and practically the same systolic blood pressure was found. Under protests from all the agency staff the man was declined. Two years later he died of apoplexy. The man was angry at being refused. Instead of looking the matter squarely in the face he thrust aside the idea that there was anything the matter with him. He had never had one ill day in his life,