Sphygmographic observations on the pulse of typhus / by Thomas Wrigley Grimshaw.

  • Grimshaw, Thomas Wrigley, 1839-1900.
Date:
1867
Catalogue details

Licence: Public Domain Mark

Credit: Sphygmographic observations on the pulse of typhus / by Thomas Wrigley Grimshaw. 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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    maximum temperature of the cases was attained sooner than when more fatal during the Autumn months. I make these remarks upon the temperature here, because I have found that the variations in the pulse correspond, in the majority of cases, with those in tempera- ture, the higher the temperature, cceteris paribus, the lower the tension, and the less marked the dicrotism of the pulse, and vice versa, as before stated. The pulse characteristic of typhus is, as a rule, best marked in proportion to the darkness of the spots; as the spots appear the pulse gradually loses its natural form, showing a low tension and -want of dicrotism; as the spots vanish the tension increases and the dicrotism returns; but after its return, and as the patient approaches convalescence, the dicrotism, in most cases I have observed, again disappears, but from a different cause, which seems to be a contracted and pinched state of the muscular fibres of the arteries, similar to that of the other muscles, which is only too evident, in the appearance of fever convalescents. In Plate I. are delineated the various forms of pulse found in typhus cases running the short course to recovery. Fig. 1 represents the pulse of the second day of the disease (of course observations on typhus so early in the disease are not easily obtained). I have only been able to observe two, the result being the form given in Fig. 1, which does not deviate much, except in frequency, from a natural pulse. Fig. 2 represents the state on the third day, showing a greater deviation from the natural form. Fig. 3, the fourth day; Fig. 4, the fifth day; Figs. 5, 6, 7, and 8, represent various forms found on the sixth day, the more common being Figs. 6 and 8; the forms 5 and 7 being found in the more severe cases. Figs. 9, 10, and 11, represent the pulse of the 7th day; Fig. 9 being the most common form. The similarity of the forms on the sixth and seventh days will at once be remarked, as also that of the eighth day, Fig. 12. On the ninth day we usually notice a return of the dicrotism (Fig. 13), as the temperature falls, and the spots begin to disappear, but the low tension still remains; the tension now begins to rise, as seen in Fig. 14, tenth day ; Fig 15, eleventh day; and Fig. 16, twelfth day; the amplitude of the pulse tracing is not always so great on the eleventh day as seen in Fig. 15. In Fig. 17, which corresponds with the thirteenth day, we see the dicrotism again becoming indistinct until the fourteenth day. In Figs. 18 and 19 we find it completely gone; from this time the dicrotism again appears, and the pulse returns gradually to its natural form, as seen in Figs. 20, 21, and