Medical diagnosis, with special reference to practical medicine : a guide to the knowledge and discrimination of diseases / by J.M. Da Costa.

Date:
1864
Catalogue details

Licence: Public Domain Mark

Credit: Medical diagnosis, with special reference to practical medicine : a guide to the knowledge and discrimination of diseases / by J.M. Da Costa. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    general maladies; and others, again, are owing to a disease of the texture itself. Tension of the skin is met with in acute affections accom- panied by active excitement. In wasting and prostrating ailments, on the other hand, the skin feels very relaxed and soft; and in those producing rapid emaciation it is inelastic and lies in folds. Pulse.—The study of the pulse, elevated into a science by Galen and his disciples, has come down to us with the sanc- tion of centuries; and to feel the beat at the wrist is still, in the opinion of many, as indispensable to the understanding of a case as it was thought to be by the Arabs, and in the middle ages. Yet the advance of science has shaken the belief in the paramount importance of the pulse. It has shown that, although a most valuable means of information, it is not exclusively to be trusted to, and has proved the many divisions and refinements of the physicians of by-gone days—who endeavored by the pulse to judge of every con- ceivable morbid condition—to be practically useless. Indeed, were even all their distinctions founded in fact, we have now better ways of judging of lesions than by feeling the radial artery. The same may be said of the prognostic indica- tions drawn from the pulse. It aflbrds us in this respect much instruction; but any attempt, at present, to revive the various critical pulses, as taught by Solano or Bordeu, would be received with the same derision as we do the pretensions of our Chinese brethren to distinguish diseases by feeling the pulse of the right or the left side, or to determine, by its aid, the sex of the child in a pregnant woman. The pulse enlightens us on the action of the heart, and on something more—on the state of the artery itself and of the blood. In a healthy adult a beat of some resistance is felt, recurring from sixty-five to eighty times in a minute, and modified by position of the body, by age, by occupation, by the process of digestion and the acts of respiration. At the bedside we study in the pulse its frequency, its rhythm, its volume and strength, and its resistance. Increased frequency of the beat denotes increased frequency of the heart's action, and may arise from any cause which