Pulse

“ There is one remarkable experiment which I would have every one try who is anxious for truth, and by which it is clearly shown that the arterial pulse is owing to the impulse of the blood. Let{125} a portion of the dried intestine of a dog or wolf, or any other animal, such as we see hung up in the druggists’ shops, be taken and filled with water, and then secured at both ends like a sausage: by tapping with the finger at one extremity, you will immediately feel a pulse and vibration in any other part to which you apply the fingers, as you do when you feel the pulse at the wrist. ”

“ But one of the most remarkable modifications of the pulse, one that is characteristic of an exceedingly acute attack of cerebral disease, and one with 109the import of which it is of the highest consequence to the life of the patient that the practitioner should be perfectly acquainted the moment he meets with it, is the slow and intermitting pulse. ”

“ Soon there is an adaptation to the change—the functions regain their accustomed office—the palpitation of the heart subsides—the pulse, which might have been fluttering and intermitting, becomes regular, though still quick and full. ”

“ A full, slow, and regular pulse, denotes a perfect state of health; for whilst the blood moves regularly in the arteries, without pain to the nervous system, or disturbance to the animal œconomy, the pulse will beat precisely regular, without trembling, fluttering, hurry, distinction, or feebleness, and discover to the touch, a peculiar easiness ”

“ In feeling the pulse the physician is to note its compressibility, frequency, regularity, size, and the different impressions it produces on the fingers. If it feels like the creeping of a serpent or a leech, wind is supposed to be predominant. ”

“ The pulse, which is the principal index of the sufficiency of the nutritive matter imbibed into the system, and of the powers by which it is appropriated to the purposes of the economy, continually misleads; so prevalent is redundancy of blood, and the energetic circulation to which it gives rise, that a pulse of perfect health is rarely met with. ”

“ And indeed every one may see, when a horse drinks, that the water is drawn in and transmitted to the stomach at each movement of the throat, the motion being accompanied with a sound, and yielding a pulse both to the ear and the touch; in the same way it is with each motion of the heart, when there is the delivery of a quantity of blood from the veins to the arteries, that a pulse takes place, and can be heard within the chest. ”

“ Any want of harmony between the heart’s action and the pulse may be observed by laying the right hand over the region of the heart and applying the fingers of the left on the radial artery. In debility and especially if from a deficiency of blood the violent or tumultuous action of the heart contrasts strangely with the weak jerking and compressible pulse. ”

“ The heart is perhaps the organ most often the object of solicitude on the part of the hypochondriac. When we realize that the pulse may vary in the healthy individual from 60 to over 100, according to circumstances, and that mere excitement may send it to the latter figure, we may appreciate the feelings of one who counts his pulse at frequent intervals and is alarmed if it varies from a given figure. ”

“ Cause of the Pulse.—The pulse, which can easily be detected by pressing the large artery in the wrist or the small one in front of and above the external ear, is caused by the gushing of blood through the arteries after each pulsation of the heart. As the large arteries pass away from the heart, the diameter of each individual artery becomes smaller. At the very end of their course, these arteries are so small as to be almost microscopic in size and are very numerous. ”

“ Because every time that the heart contracts it send a fresh supply of blood to the blood-vessels, and the motion thus imparted creates a general pulsation throughout the system: but it is more distinctly perceived at the pulse, because there a rather large artery lies near to the surface. ”

“ In old age the pulse is faster than in middle life; in children it is quicker than in adults.
Fig. 79.—Circulation in the Capillaries, as seen with the Microscope.
As the pulse varies much in its rate and character in disease, it is to the skilled touch of the physician an invaluable help in the diagnosis of the physical condition of his patient.
Experiment 92. To find the pulse. Grasp the wrist of a friend, pressing with three fingers over the radius. Press three fingers over the radius in your own wrist, to feel the pulse. ”

“ When the fit begins to pass off, respiration becomes more distinct, the patient utters a few long-drawn sighs, the heart begins to act with more energy, the pulse at the wrist becomes more perceptible, some color appears in the face, and the consciousness is again 141restored. ”

“ The pulse is generally about 120 when in bed and in the morning; and is increased to 134, or more, when the patient sits up, or in the evening paroxysm. The pulse of all very weak patients increases in frequency when they sit up; because the expenditure of sensorial power necessary to preserve an erect posture deducts so much from their general strength; and hence the pulse becomes weaker, and in consequence quicker. See Sect. XII. 1. 4.
In this fever time must be allowed for the absorption of the matter. ”

“ It has been already observed, that the pulsations of the artery which we feel at the wrist, are occasioned by its alternate dilatations and contractions, which vary according to the strength and regularity of the circulation, which is liable to be affected by the smallest changes in the state of health. Hence physicians make use of the pulse as a criterion whereby to judge of the health of the body. And we may observe that there are few more certain characteristics of the state of the body than the pulse ”

“ The Heart and Blood-vessels.—By exercise the heart’s action is increased in frequency and force. The pulse usually increases from ten to thirty beats per minute above the rate while at rest.251 After prolonged exercise it may temporarily fall below the normal standard. ”

“ If a disinterested observer could record the pulse as normally beating and the pulse under the conscious influence of the mind, it would be found that the pulse under the conscious effort is beating either more rapidly or more slowly or that it is not beating as regularly as in the case of unconscious or reflex action. ”

“ The pulse varies; in some it is full and laboring, in others quick and jerking; the head, face, and neck are livid and congested; the carotid pulsation is very perceptible; the pupils, at first contracted, dilate widely before death. ”

“ A full pulse, then, as Archigenes defines it, is one which indicates an artery that is completely full, and the impression of which is, that it is distended with fluids; and an empty one conveys an impression as if its contents were full of bubbles of air, so that the finger, when pressed upon it, seems to fall into an empty space. These five kinds of pulses regard one motion of the artery. And since the quality of the heat in the heart may be more developed than usual in the artery, some have hence reckoned a sixth kind of pulses. ”

“ Why, the feeling of a man's pulse for half an hour, and timing it as you would a trotting horse, is enough to make a well man sick. What a doctor wants to do is to feel of a man's pulse about one second, and then throw the patient's hand down and say: “O, you are all right. ”

“ The pulse has always been very much to the front in the treatment of disease; there are at least twenty-four varieties of pulse with which every doctor is supposed to be familiar, and some eminent doctors have claimed to distinguish no fewer than seventy-two. ”

“ An irregular full pulse, is at all times a bad one; many may be the causes, 54and generally denotes a great confusion in the nervous system, and in the circulation of the blood. This pulse is generally the attendant on violent inflammations, phrenzy, delirium, &c. and if it continues any time, forebodes great danger: bleeding in time is greatly requisite, and other remedies, in order to assist the nerves, and bring the circulation to its proper regulation again. ”

“ The pulse is now much weaker and more rapid, and may be irregular. The color returns to the face, the patient closes his eyes, and the body is covered with profuse perspiration. The fingers are unlocked and every evidence of spasmodic movement disappears. ”

“ Irregularity of the pulse generally indicates disease, and there are two varieties of it. In most instances of irregular pulse, succeeding beats differ in length, force and character; in the other variety a pulsation is from time to time left out; the pulse is said to intermit. ”

“ As soon as the instrument was introduced, the pulse increased to 144, and immediately afterwards it became uneven, irregular, and intermitting. I could not count more than three or four beats at a time; and, occasionally, when the pain seemed greatest, and the man was straining and holding his breath, the pulse was altogether absent for four or five seconds. ”

“ A regular pulse in such persons indicates a disease, as it shows the system to be under the impression of a preternatural stimulus of some kind. This observation was suggested to me above thirty years ago by Morgagni, and I have often profited by it in attending old people. The pulse in such patients is an uncertain mark of the nature, or degree of an acute disease. It seldom partakes of the quickness or convulsive action of the arterial system, which attends fever in young or middle-aged people. ”

“ In such cases we have palpitation of the heart, both subjective and objective, a weak and compressible pulse, often irregularity of the heart’s action, singularly clear heart sounds, often, however, systolic murmurs at various orifices, increased frequency of heart and respiration to a disproportionate degree on slight exertion, strong pulsation of the carotids, and slight œdema of the ankles. ”

“ A soft pulse follows a humid state of the artery. An artery is rendered more humid by things not preternatural, such as more liquid food, immoderate baths, much sleep, a more abundant diet, and hilarity; and by preternatural causes, such as coma, lethargy, dropsy, and the other pituitous affections. A full pulse indicates an abundance of fluids, or plethora from food, or from drinking wine, as the empty, on the other hand, indicates deficiency of food or evacuation. ”

“ The pulse will be the only true guide. If it is weak, wavering, and irregular, we must avoid depleting, purgative agents. The blood flows through the arteries, impelled by the action of the heart, and its pulsations can be very distinctly felt by pressing the finger upon almost any of these arteries that is not too thickly covered by fat or the cellular tissues of the skin, especially where it can be pressed upon some hard or bony substance beneath it. ”

“ The pulse that suggests the running of a partridge is called delirium pulse. An irregular pulse indicates delirium tremens, and a pulse which is almost imperceptible, depressed, irregular, and extremely languid, is a precursor of death. Pulsations in one suffering from fever or amorous passions are quick, and in a healthy man they are of a medium strength and perfectly regular. The capriciousness of the pulse produces other modifications very curiously described. ”

“ Dryness of the heart renders the pulse hard, and the passions ungovernable, fierce, and difficult to quell; and, for the most part, the whole body is drier than usual, unless the parts about the liver antagonise. These are the marks of a more humid temperament: a soft pulse, a disposition easily roused to anger, and easily pacified, and the whole body more humid than common, unless antagonised by the parts about the liver. When the temperament is both hotter and drier, the pulse is large, hard, and quick and dense ”

“ For instance, the pulse-wave travels at the rate of about 30 feet a second, and takes about 1/10 of a second to reach the wrist, while the blood itself is from 3 to 5 seconds in reaching the same place. ”

“ The pulse not only varies in number of beats per minute during illness, but also in character—for instance, after great exertion the pulse is full and fast, and in cases of internal inflammation it is small and wiry as well as fast. ”

“ The Pulse.—With each contraction of the left heart, the impulse causes a wave-like motion to traverse the entire arterial system. If the arteries were exposed to view, we might see successive undulations speeding from the heart to the smallest of the branches, in about one-sixth part of a second. ”

“ When any difficulty occurs in determining the weak pulse from the strong one, it may generally be assisted by counting its frequency. For when an adult patient lies horizontally in a cool room, and is not hurried or alarmed by the approach of his physician, nor stimulated by wine or opium, the strong pulse seldom exceeds 118 or 120 in a minute ”

“ An irregular pulse, one that beats fast for a time, then slowly, indicates a weakened heart condition. A slow, full pulse, one that comes up gradually to the finger touch, indicates some brain trouble. ”

“ A pulse which is great from putrefaction of the fluids has a contraction more hasty than natural joined to its greatness. To form a great pulse, an urgent necessity is not alone sufficient; but the vital powers must also contribute, and a condition of the instrument or artery intermediate between hardness and softness. When the heat, therefore, is increased in the heart by any of the above-mentioned causes, in the first place the pulse becomes great, and, the greatness not being able to supply the want, quickness is straightway joined to it ”