Outlines of pathological semeiology / translated from the German of Professor Schill ; with copious notes by D. Spillan.

  • Schill, Albert Friedrich, 1812-1839. Grundriss der pathologischen Semiotik. English
Date:
1841
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Licence: Public Domain Mark

Credit: Outlines of pathological semeiology / translated from the German of Professor Schill ; with copious notes by D. Spillan. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    from hypertrophy of the left ventricle. The small pulse {p. pawns) is occasioned either by narrowing of the aortic opening, by atrophy, considerable eccentric hypertrophy of the heart, or the mass of fluid is diminished, the strength is sunk, as after profuse evacuations, suppurations, hemorrhages, at the end of chronic diseases, in the transition to gangrene and suppuration. If it is then at the same time weak and soft, the prognosis is bad. In spasms, and at the commencement of inflammations, it is small and hard, without rendering the prognosis worse. 301. The tension of the pulse depends chiefly on the tone of the arterial parietes. The hard pulse {p. dunes) gives a certain mea- sure for the inflammatory and spasmodic tension which is produced by inflammations, more especially of the serous [and fibrous] mem- branes, the lungs, the heart, and arteries, and by hysterical and hypochondriacal paroxysms. So long as the pulse retains its hardness, inflammation or spasm is present. The longer it holds, the sooner is suppuration or indu- ration to be dreaded. The hard pulse in spasms is distinguished by its smallness and irregularity from the inflammatory hard pulse, which, except in abdominal inflammation, is at the same time strong and regular. If a hard pulse appear in chronic diseases not inflammatory, an inflammatory complication may be suspected. It precedes active hemorrhages. However, it must not be for- gotten that cartilaginous formations and ossifications of the arteries also produce hardness of the pulse. As varieties of the hard pulse may be considered the rigid pulse (p. rigidus), the hardish pulse {p. duriusculus), the skipping pulse {p. caprizans), and the hammering pulse. The rigid pulse is caused by ossification of the arteries, or hypertrophy of the heart. The hardish pulse marks the transition into inflammation and that into suppuration and absorption. The skipping pulse is a combi- nation of the hard, rapid, and unequal pulse. A hard, rapid stroke is followed by a weaker one. To its formation, increased con- tractility of the arteries, as well as inequality in the heart's con- tractions, seem to contribute. These conditions are found united in hysterical spasms, in critical disturbance, and the last struggle in those who die when inflammation is at its height, or in conse- quence of apoplexy. The hammering pulse is a combination of the hard with the fre- quent and rapid pulse. It is observed in arteritis and in rheuma- tism, especially when it attacks the circulatory apparatus. 302. The soft pulse indicates diminished contractility of the arteries. It shows itself under two orders of circumstances: (1) combined with extreme debility in the nervous stage of typhus, in plague, towards the end of chronic diseases, in the transition from inflammation to suppuration and gangrene ; it is ordinarily at the same time weak, unequal, and irregular; the prognosis in these cases is bad ; (2) in irritations and inflammations, when the critical secretions occur; hence a soft pulse accompanies catarrh of the 10
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