The bearings of chronic disease of the heart upon pregnancy, parturition, and childbed : with papers on puerperal pluero-pneumonia and eclampsia / by Angus MacDonald.

  • Macdonald Angus, 1836-1886.
Date:
1878
Catalogue details

Licence: Public Domain Mark

Credit: The bearings of chronic disease of the heart upon pregnancy, parturition, and childbed : with papers on puerperal pluero-pneumonia and eclampsia / by Angus MacDonald. Source: Wellcome Collection.

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

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    indicate low tension, inasmuch as he found what appears to him a similar tracing in that of a hemiplegic patient whose case is recorded by Eulenberg, and whose vascular tension must have been feeble. As already stated, Dr. Meyburg agrees with other observers in regarding the pulse tracing before delivery as indicative of high arterial tension. Thus far I agree with him. But I disagree with him toto ccelo when he deals with the pulse of the lying-in woman. I allow that the tension immediately after delivery is less high than before labour. But I maintain that it is not so much less as to entitle us to call it a pulse of low tension. Furthermore, I consider that it is a pulse of distinctly higher tension than that of the ordinary healthy woman, and I have failed to satisfy myself that it possesses the characteristics which Dr. Meyburg describes as peculiar to it. In my experience with the sphygmograph, a slanting and short up-stroke in such cases is only to be obtained by a defective applica- tion of the instrument. I appeal with confidence to the tracings which follow in support of this contention. I have not been able to get a low-level secondary wave. It will be noticed that the tidal or secondary wave is in general not so well marked in the tracings obtained after delivery as in those taken before it. The only exception is when the pulse rate is slow, and then the tidal wave is particularly full. But it will be observed that with this well-marked tidal wave and slow pulse there is invariably found to coin- cide a high working pressure and a fully average obliterating pressure. Besides, shortness of up-stroke is far from indi- cating a pulse of feeble tension. The length of up-stroke seems to measure rather the degree of capillary resistance, and to vary inversely with the latter. Some comparatively feeble pulses have a very high up-stroke. In the case of Mrs. Moodie, p. 88, it will be noticed that, in the tracing obtained after her delivery, a diminution of 2 ounces of working pres-