The venous and liver pulses, and the arhythmic contraction of the cardiac cavities / by James Mackenzie.

  • Mackenzie, James, 1853-1925.
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: The venous and liver pulses, and the arhythmic contraction of the cardiac cavities / by James Mackenzie. Source: Wellcome Collection.

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

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    observed as a common result of tricuspid incompetence is that the overplus is^ taken up by the capacious auricle and vena cavad The means at his command did not permit the deraunstration of the manner in which this modifying influence takes place. By the method I have now devised—the use of the clinical poly- graph the movements of the veins and the time of occurrence of them ^ movements can be readily demonstrated, and the causes of each individual movement inferred. Hitherto great varieties of movements have been described, and a great variety of causes as producing them. It will be found that all these varieties are simplified, and that even mere vibratory tremors can be registered, that each vibration has a distinct and characteristic significance, and that its cause can readily be recognised (Figs. 76 and 108). Eecognising, then, more accurately, each individual feature, the variations with the changing conditions of the heart form an interesting and somewhat complex study, more particularly when there is distinct evidence of the lack of rhythm between the actions of the various chambers of the heart. Clear and distinct as the movements constitutmg the venous pulse are, there are still many features left unexplained. The subject is one of greater proportions, and affords opportunities for more careful observation than one would at first imagine. The venous pulse being so sus- ceptible to the most subtle changes in the circulatory and respiratory systems affords evidence of the most delicate type of any influence affecting those systems. A few of these changes only can be indicated in this paper, but they are such as to lead one to hope that, with a more accurate knowledge of the subject, a comparatively wide field for clinical observation will be opened up. In drawing up this paper I have been careful to avoid merely the registration of exceptional cases, but have extended my observations over a large number of patients (about 500), and under a great variety of conditions. The explanation given of the features of that form of pulse called the auricular form, which is by far the most common, has been as applicable to every case as it is to those recorded in this paper. Usually, however, the features in cases presenting the form of pulse called the ventricular, have individual peculiarities of which those here recorded may be taken as examples. If care be taken to have the venous pulse registered at the same time as the arterial pulse (carotid or radial), little difficulty is experienced in determining the nature of each feature. Whilst I shall frequently have occasion to refer to the erroneous views of others, I am conscious that where so many more competent observers have erred, it is but likely that I should go astray. The necessity, therefore, has been kept distinctly in view in composing this paper, of giving a clear conception of the facts, as distmct from the ^ King, T. 'VV., “ The Safety-Valve Function in the Right Ventricle of the Human Heart,” Guy’s Hospital Reports, 1837, vol. ii. p. 132.