Paradoxical, hyperdicrotic, and hemisystolic pulsation / by G. A. Gibson.

Date:
1903
Catalogue details

Licence: In copyright

Credit: Paradoxical, hyperdicrotic, and hemisystolic pulsation / by G. A. Gibson. 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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    by subsequent pulsation. The existence of such tracings is sufficient in itself to demonstrate that Mackenzie’s conclusions, in regard to the origin of hyperdicrotism, are at least too absolute. It is only right to add that he himself admits that this may be the case, for, in a private communication to me he says ^:—“ I readily admit there may be other instances which I have not met.” On the other liand, it is but just on my part to state my conviction that Mackenzie’s views are of very general application. Fio. 6.—Tracing oi pulse in mitral disease, showing hyperdicrotism during most of the curve. The flow of fluid through elastic tubes still remains one of the most abstruse subjects connected with tlie circulation, and in spite of the labours of many observers there are many points as yet obscure. Amongst tliese vexed questions, dicrotism must be regarded as one of the most difficult. It cannot be doubted that the dicrotic wave is of centrifugal origin, although it is certain Fig. 7.—Tracing of radial pulse (below) and jugular pulse (above) in adherent pericardium. The second and third, as well as the seventh and eighth radial pulsations, are grouped or bigeminal, but the jugular pulsation is not doubled. that centripetal forces modify it to some extent. Its amplitude may be taken to vary inversely with the arterial pressure, and for the occurrence of hyperdicrotism the one constant factor is a low level of that pressure. In this connection it is therefore a matter of real interest to find hyperdicrotism, during the phase of inspira- tion, in the paradoxical pulse. Let us now turn to the other subject which arises out of the * Letter dated July 13, 1903.