The physical signs of cardiac disease : for the use of clinical students.

  • Graham Steell
Date:
1891
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Licence: Public Domain Mark

Credit: The physical signs of cardiac disease : for the use of clinical students. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    iFiG. I.—(The late Dr. Mahomed.) Shows a method of gauging tension. The tracing will Serve to illustrate the principal features of a pulse curve. There is the upstroke, then a depression forming with the upper portion of the upstroke the percussion wave. An elevation, the tidal wave, succeeds. This wave terminates with the aortic notch (B) which indicates the end of systole and the beginning of diastole. The elevation immediately following this notch is the dicrotic wave. A line drawn through the lower extremities of the series of upstrokes is called the respiratory line. The tracing represents a pulse of considerable tension, and it will be noticed that the tidal wave rises above the dotted line drawn from the summit of the upstroke to the aortic notch. The aortic notch, again, is at a considerable height above the respiratory line. The old and best known nomen- clature is retained here. Drs. Roy and Adami, in their paper already referred to, propose to name the percussion wave the papillary waveand the tidal wave the outflow-remainder wave. Their observations, further, seem to throw some doubt upon the suitableness of the terms high and low tension, in common use, as applied to tracings presenting the characteristic features, which are illustrated in the following tracings. Fig. 2.—(Mahomed.) Showing high tension, case there was no albumen in the urine. In this IiG. 3.—(Mahomed.) Low tension and dicrotic pulse. I'he aortic notch ap- proaches the respiratory line. Fig. 4.—(Mahomed.) Fully dicrotic pulse. The aortic notch^reaches the respira- tory line. F'G. 5.—(Mahomed.) H>-perdicrotic pulse. The aortic notch falls below the res- piratory line. Fir,. 6.—(Mahomed.) Tracing showing l)ronoiinccd tidnl and dicrotic waxes.
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