A comparison of the auscultatory blood pressure phenomenon in man with the tracing of the Erlanger sphygmomanometer / by Arthur W. Weysse and Brenton R. Lutz.

  • Weysse, Arthur Wisswald, 1867-
Date:
1913
Catalogue details

Licence: In copyright

Credit: A comparison of the auscultatory blood pressure phenomenon in man with the tracing of the Erlanger sphygmomanometer / by Arthur W. Weysse and Brenton R. Lutz. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Lang and Manswetowa (1908), comparing the auscultatory method with the oscillatory method of v. Recklinghausen, found that when the first sound was heard the amplitude of the oscil- lations showed a marked increase. During the 3rd phase the intensity of the sounds and the amplitude of the oscillations were proportional. At the moment the amplitude began to decrease the sounds became dull, indicating the onset of the 4th phase. This first decrease in the height of the oscillations and the beginning of the 4th phase, these authors believe indicate mini- mum blood pressure. Experiments with two large dogs led them to the same conclusion. Van Westernrijk (1908), comparing simultaneously the aus- cultatory method with Uskoff’s graphic method, found no constant relation between the 4th phase and the maximum oscilla- tions obtained with the Uskoff sphygmotonograph. (Erlanger [1908] shows that the Uskoff sphygmotonograph has a physical defect.) He observed, however, a definite relation between the auscultatory phenomenon and the oscillations of Pal’s sphygmo- scope. The marked increase in amplitude of the oscillations was coincident with the first sound, and the sudden diminution in amplitude occurred at the beginning of what is now called the 4th phase. Fischer (1908), comparing the auscultatory method with the oscillatory method of v. Recklinghausen, found in 150 cases, normal and abnormal, the maximum determined by both meth- ods agreed 58 times. In 92 cases the oscillatory maximum was higher than the auscultatory maximum. In these same 150 cases he determined the minimum pressure by both methods and found it agreed in 47 cases; in 97 cases the oscillatory min- imum was lower than the auscultatory; in 6 cases it was higher. He concluded the 4th phase to be the most accurate index, and found in cases of long 4th phase a low minimum pressure, and in cases of short 4th phase a high minimum. Gittings (1910), and Goodman and A. A. Howell (1910) con- sider the 5 th phase as an index to minimum blood pressure. The latter even go so far as to say that “it is generally agreed that the disappearance of all sound is coincident with minimal or diastolic pressure.” Gittings found in 41 cases out of 48 that