Some clinical observations on blood pressure with special reference to the effect of prostatic massage / by David Murray Cowie.
- Cowie, David Murray, 1872-1940.
- Date:
- [1910?]
Licence: Public Domain Mark
Credit: Some clinical observations on blood pressure with special reference to the effect of prostatic massage / by David Murray Cowie. Source: Wellcome Collection.
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![[Reprint from American Medicine, New Series, Vol. V, No. 12, pages 632-643, December, 1910.] BLOOD PRESSURE WITH SPE- ier REFERENCE TO THE ‘FECT OF PROSTATIC MASSAGE.1 BY, DAVID MURRAY /COWIBE, M. D., _ Clinical Prof. Pediatrics and Internal Medicine, Univ. Mich. Ann Arbor, Mich. In discussing the subject of blood pres- sure from clinical standpoints I do so not with the intent of adding anything espec- lally new to our general knowledge of this very important subject, unless it be the effect of prostatic massage. Altered blood pressure must be considered a symptom or state and not a disease. It is dependent upon such a variety of conditions that its clinical interpretation is often difficult and sometimes misleading. Several years ago in a discussion on this subject I heard it stated that nitroglycerine and nitrites in general have only a transitory effect in lowering blood pressure due to arterial dis- ease Or other causes. My experience at least seemed to me to be different. I had re- peatedly noted what I thought permanent or prolonged changes in the character of the pulse under the use of the nitrites. At the time of the discussion I had no definite data at hand with which to substantiate my so active in keeping records as perhaps I should. Read by invitation, Kalamazoo Academy of Medicine. (Mich. ) Compleuesla There are many recorded observations of the changes which occur in blood pres- sure after the administration of a dose of nitroglycerine. There is always a quick and marked fall and a gradual return to the normal point, the whole phase lasting not longer than fifteen or twenty minutes. Accordingly this drug has been employed chiefly stance in for its transient effect, as for in- attacks of angina _ pectoris, asthma, or apoplexy. In looking over my cases | have picked out a few that will serve to illustrate the points I wish to con- sider this afternoon. I think the majority of observers are of the opinion that the sense of touch is not trustworthy for comparative blood pres- sure records, although no less an authority than Sir William Broadbent emphatically stated at the Toronto meeting of the British Medical Association, that the edu- cated finger is better than any instrument. By this method we make a note today of a blood vessel being straight or tortuous; its tension high, good, fair, or low; its quality full, small, quick, rapid or thready ; its bulk plainly felt after compression, and tomor- row, or more frequently several days later we make another observation with only our memory to serve us as a comparison of the degree of alteration. The feeling of many pulses in the interim has doubtless distorted our accuracy of judgment. In making blood pressure records 1 have frequently found my previous opinion of the character of the pulse altered by its expression in millimeters of mercury. The hard full pulse with an up stroke that misinterpreted. It is always one that goes with high tension. Shading differences of such a pulse are difficult to recognize. For the most of us some instrumental means of eae ee a](https://iiif.wellcomecollection.org/image/b33432119_0001.jp2/full/800%2C/0/default.jpg)
