A comparison of the auscultatory blood pressure phenomenon in man with the tracing of the Erlanger sphygmomanometer / by Arthur W. Weysse and Brenton R. Lutz.

  • Weysse, Arthur Wisswald, 1867-
Date:
1913
Catalogue details

Licence: In copyright

Credit: A comparison of the auscultatory blood pressure phenomenon in man with the tracing of the Erlanger sphygmomanometer / by Arthur W. Weysse and Brenton R. Lutz. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    pressure, and Erlanger (1904) has shown with an artificial circu- lation, in which was inserted a piece of artery, that maximum oscillations are obtained with his instrument at minimum pres- sure. Hence he considers the marked decrease in amplitude of the oscillations as an index for minimum blood pressure. In the auscultatory method described by Korotkoff in 1905 we now distinguish the five phases first recognized by Ettinger (1907), as follows; ist, first sounds, clear; 2d, murmurs; 3d, clear sounds; 4th, dull sounds; 5th, cessation of the sounds. All observers agree that the beginning of the ist phase is coincident with maximum pressure. But the criterion for mini- mum pressure is in dispute; such observers as Eischer (1908), Lang and Manswetowa (1908), Van Westenrijk (1908), and Warfield (1912) consider the beginning of the 4th phase as the auscultatory index for minimum pressure; while Ettinger (1907), Gittings (1910), and Goodman and A. A. Howell (1910) con- sider the 5 th phase as the correct index. A Brief Review of the Literature Korotkoff (1905), as reported by Schrumpf and Zabel (1909), heard the first sound before the pulse could be palpated at the wrist, the difference being represented by from 10 to 12 mm. of Hg. He measured the minimum pressure after the “endtone,” i.e. at what is now called the 5th phase. Ettinger (1907) compared the auscultatory with the palpa- tory and graphic methods. He considered the first sound as an index to maximum pressure, and the cessation of all sounds, i.e. the 5th phase, as an index to minimum pressure. Out of 232 determinations, he found that 207 times the auscultatory maxi- mum was higher than the graphic maximum (Janeway-Massing) or the palpatory maximum (Strassburger). Out of 227 deter- minations of the minimum pressure he found that 130 times the auscultatory minimum was lower than the palpatory or the graphic, 18 times it agreed with them, 71 times it was higher than either, and 8 times between the two. In general he found the maximum higher and the minimum lower with the auscul- tatory method.