A manual of medical diagnosis / by A.W. Barclay.

  • Andrew Whyte Barclay
Date:
1857
Catalogue details

Licence: Public Domain Mark

Credit: A manual of medical diagnosis / by A.W. Barclay. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    56/642 (page 32)
    ( 32 GENERAL CONDITION OF THE PATIENT. I pression that one or other condition is most probably j ]iresent. The age of the patient has an important influence) over the frequency of the pulse; sex and habit over! its fulness and flrmness. ' Tlic pulse maybe quickened by mere excitement; the tongue! may be at the same time coated from disorder of the bowels ; but i this condition must not be mistaken I'or fever, nor, if associated in 1 a delicate female with pain in the left side, be taken as indicative ’ of pleurisy. The state of the skin, as well as the absence of thirst; and the cliaracter of the urine, will here probably decide against j any such supposition. Acceleration of pulse, to be important, must I be constant and persistent, not transient and varying with tern-; porary excitement, &c. Certain chronic states are also accom-.' panied by acceleration of pulse, such, for example, as heart disease and phthisis; and here again the indications from other sources, even without considering the special indications derived from its force or firmness, enable us to correct an impression of acute or' febrile disorder. < Changes in volume chiefly give rise to impressions of the pulse j being full or empty, large or small; but these are necessarily asso- i dated with conditions of hardness or softness, strength or weak- ness, which arc; expressive of changes in force. The impressions; of this character are conveyed to the finger by the greater or less i degree of compressibility; the pressure required to obliterate the ‘ current. Deviations occurring within the limits of health gene- rally combine fulness with firmness, weakness with smallness. We do not expect to find a similar pulse in a man of sedentary occupation, and in one of active, or perhaps laborious, pursuits: the pulse of the female has neither the fulness nor the force of the other sex. And while these point to real differences in con- stitution, which guide us in the adaptation of remedies, they are not the less to be borne in mind in judging of the extent of devia- tion in disease. Certain names liave been given to unusual combina- tions of the characters just mentioned, with which the student must make himself acquainted: thus small-fl ness, with force, gives rise to what is termed a hard | pulse, or, in extreme cases, a wiry pulse; lai’geness, with want of force, to a soft jnilse; emptiness and fre- quency to what is often called a rajiid pulse. Irregularity of pulse has very important bearings upon special forms ol disease, but is of less consequence as a symptom of the general condition of the patient.