Quinquennium of medicine and surgery : being the first supplementary volume to Green's Encyclopedia and dictionary of medicine and surgery / edited by J.W. Ballantyne.

Date:
1911
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Licence: In copyright

Credit: Quinquennium of medicine and surgery : being the first supplementary volume to Green's Encyclopedia and dictionary of medicine and surgery / edited by J.W. Ballantyne. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    Folia haematologica, Hefte 10 and 11, 1906. (Gulland's paper is a good general review of the classification and origin of the leucocytes.)—Blood ix Childrp:n. —Hutchison. Goulstonian Lectures, Lancet, March 7, 14, 21, 1904.—Clinical Examination.— GuLLAND. Scotf. Med. and Surg. Jonrn., Dec. 1906. —Hastings. New York Med. Journ., August 25, 1906.—Glycogen Reaction.—Gulland. Brit. Med. Joum., April 16, 1904.—Locke and Cabot. .Journ. Med. Research, vol. vii., 1902.—Locke. Bo»t. Med. and Surg. Journ., 1902.—Stains.—Baumgarten. Amer. Med., Jan. 2, 1904.—Jenner. Lancet, vol. i. p. 370, 1899.—Leishman. Brit. Med. Journ., vol. ii. p. 757, 1901.—HEMOGLOBIN.—Tallquist. Archives yin. de med., p. 421, 1900.—Haldane. Journ. Phys., xxvi. p. 497, 1901.—Neutrophile Cells.—Arneth. Miinch. med. Wochenschr., Nos. 25 and 45, 1904.— Alkalimetry.—Dare. Phila. 3Ied. Journ., p. 137, 1903.—Coagulation Time.—Addis. Quarterly Joum. Exper. Phy,^., Nov. 1908; Quarterly Joiirn. Med., Jan. 1909 (gives references).—Calcimetry.—Blair Bell. Brit. Med. Journ., April 20, 1907. Blood - Pressure.—Blood- Pressure, Measurement of.—The instruments employed for estimating the blood-pressure clinically may be divided into two groups—(1) those which compress a single artery; and (2) those which compress the whole circumference of a digit or limb. Of the very many forms of apparatus which have been devised, the following may be mentioned:— 1. Vmi Bascli's Sphygmomanometer.—Although this instrument has been superseded, and is now almost obsolete, it deserves mention as one of the earliest which was of pi'actical use. It consisted of a mercurial manometer con- nected with an air-chambei' ^vith an elastic membrane, which was depressed on the radial artery until pulsation in the distal portion of the vessel ceased. The pressure required for this was read on the manometer. Von Basch's sphygmomanometer was subsequently modified moi'e than once, and an aneroid was substituted for a mei'curial manometer. 2. Oliver s Hamoilj/namometer.—Oliver points out that the principle of ascertaining arterial pressure by the force which is needed com- pletely to close the vessel is vitiated by the resistance of the overlying tissues (this, how- ever, is not admitted by many authorities), as well as by the diflf'erent anatomical relationships of different arteries. The haimodynamometer, which consists of a pad containing fluid actuat- ing a spring manometer, gives readings on a dial. The first intention of the inventor was to eliminate the al:>ove fallacies by using the instrument to indicate the pressure required to e'S'oke a maximum oscillation of the indicator, which is regarded as the criteiion of the diastolic blood-pressure. He finds, however, that in using the instrument two maximum oscillations of the needle occur, separated by a period of lessened excursion. He looks on the second of these maxima as indicating the systolic pressure. The following directions are given for the use of the hajmodynaraometer :— The right arm on its ulnar side is placed on a table (this being on a level with the ensiform cartilage in the sitting posture, and with the back in the lecumbent position), and the wrist is kept bent to the angle of forty-fi^'e degrees by the observer's left hand holding back that of the patient. The feet of the slide [of the hsemodynamometer] are so placed as to elude the track of the aitery, and the pad of the instrument is placed over the vessel at right angles to its bed. Pressure is then made by gently and gi'adually pushing forward the body of the instrument by the thuml) of the observer's right hand holding the slide. The indicator will then rise on the dial and show the degi'ee of pressure bi'ought to bear on the pad and the ^'essel, and will begin to pulsate when measuring 50, 60, 70, or 80 mm. or so. The pulsations gi'adually increase in size as the indicator is made to rise farther on the scale, until the lower maximum point is reached (diastolic I'eading), beyond which they gradually diminish, and again increase under a higher pressure until a second maximum oscillation is produced (the systolic reading), after which they finally decrease. The read- ings are made at the midway point of the maximum oscillations. It is easier to read accurately when the oscillations are small, hence the ulnar artery or the supei'ficialis ^^olaj may be employed instead of the I'adial. The hsemodynamometer gives identical readings to the armlet method, except when the brachial artery is sclerosed, in which case the armlet readings, particulai'ly the systolic pressure, are higher. 3. Gltrf7ier's Tonometer. — This may be in- stanced as a typical appai-atus based on the princijile of using a band encircling a finger to estimate the pressiu-e. It consists of a metal collar lined by an elastic membrane, with arrangements for pumping air between the elastic membrane and the metal, and for measuring the pressure in the air-containing space. The collar is placed loosely over the middle phalanx of a fingei', and the terminal phalanx is blanched by bandaging it from its tip upwards with a piece of rubber tubing. Air is then pumped into the elastic bag- lining the collar until the manometer indi- cates a pressiu'e above that of the blood, e.g. 200 mm. Hg. The rubber bandage is then unwound, leaving the end of the finger pale and bloodless. Next, the air is allowed to escape slowly from the collar until the finger- tip shows a return of the cii'culation. The manometer reading at this point indicates the systolic arterial pressure. The tono- meter is adapted foi' use either with a mercui'ial or an aneroid manometer. 4. liiva-Iiocci Sphygmomanometer. — In this appliance the pressure is measured by means of an armlet encircling the whole uppei' arm.
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