The Year Book of Medicine (Paperback)

This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1903 edition. Excerpt: ...and of the radial pulse. To the second there was no corresponding pulse in the artery, but a slight pulse could be felt in the carotids. The interval between the first and second apex heat was much shorter than that which followed the second heat. The frequency of the pulse had formerly been 88 per minute but at the time of this observation it was 44 per minute while the apex beats numbered 88. Pulsus Paradoxus. Under this term is described a condition of the pulse in which it grows distinctly smaller and weaker during inspiration. The condition is an exaggeration of a physiologic change which does not, however, make itself perceptible to the finger, nor make any impression on the sphygmograph. It is due to the negative inspiratory pressure. Pulsus paradoxus was first noticed in cases of mediastino-pericarditis by Widemann (1856) and later by Kussmaul,2 who made the diagnosis of mediastinal pericarditis in two cases upon this symptom, confirming his conclusions by autopsy. F. Riegel3 divides the cases of pulsus paradoxus into three groups according to the cause of the phenomenon. In the first class the phenomenon is due purely to mechanical pressure upon the vessels within the chest by which the pulse is obstructed. To this class belong the cases of mediastino (1) Berliner klinische Wochenschrift, March 9, 1903. (2i Berliner klinische Wochenschrift, 1873. (3) Deutsche medicinische Wochenschrift, May 14, 1903. pericarditis described by Kussmaul. The pressure in these cases is exercised upon the veins as well as upon the arteries and results in venous pulsation as well as weakened pulse. The venous pulsation is a valuable sign of the mechanical nature of the obstacle. " Other growths or pathologic accumulations within the chest may...