Student's guide to the examination of the pulse, and use of the sphygmograph / by Byrom Bramwell.
- Byrom Bramwell
- Date:
- 1883
Licence: Public Domain Mark
Credit: Student's guide to the examination of the pulse, and use of the sphygmograph / by Byrom Bramwell. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![health, as it is, for example, in some cases of aortic regurgi- tation, and in conditions of cardiac excitement, the up-stroke is quite vertical, or (in tracings taken with Marey's instrument) it may even slope backwards. (See figs. 20 and 21.)^ Fig. 20.—Piihe-ttacugduring Cardiac Excitement. Fig 21.—Aortic regurgitation. Vice versa when the ventricular contraction is slow and hesitating, as in some cases of cardiac debility ; when the aortic cusps are rigid ; when the arteries are obstructed either by internal or external causes, such as the pressure of a tumour, the presence of an atheromatous patch (at the orifice of the innominate in the case of the right radial for example) ; or, when a globular aneurismal dilatation is situated between the heart and the vessel {i.e., the radial), the up-stroke may be oblique. (See figs. 22 and 23.) Fjg. 22.—Pressure i\ oz. Fig. 22.—Aortic Stenosis.—]. B., aet. 5r, admitted to Newcastle Infirmary under Dr Byrom Bramwell, 29th November 1878, suffering from anaemia and dropsy. There was a well- marked aortic systolic murmur ; the left ventricle was not hypertrophied. The pulse- tracing seems to show that the murmur was organic, and not hsemic Fig 23 —(Left radial ) Pressure 2\ oz. Fig. 23 —Aneurism of Left Subclavian.—]. M., set 50, admitted to Newcastle Infirmary under Dr Byrom Bramwell, 5th September 1878 ; all the waves in the tracing are obliterated. * In cases of hypertrophy of the left ventricle with high arterial pressure, the ventricular contraction may be laboured and prolonged in order to overcome the obstruction, but the commencement of the contraction is sudden, and the up-stroke vertical.](https://iiif.wellcomecollection.org/image/b21043334_0026.jp2/full/800%2C/0/default.jpg)
