Arteriosclerosis and Hypertension, with Chapters on Blood Pressure: 3rd Edition. — John Shaqi
Arteriosclerosis and Hypertension, with Chapters on Blood Pressure: 3rd Edition.Warfield, Louis M. (Louis Marshall)
Science
Arteriosclerosis and Hypertension, with Chapters on Blood Pressure: 3rd Edition.
Warfield, Louis M. (Louis Marshall)
Arteries -- Diseases; Blood pressure
There are several instruments which are in common use for the purpose of
recording blood pressure in man.
Historically, the determination of blood pressure for man began with the
attempt of K. Vierordt in 1855 to measure the blood pressure by placing
weights on the radial pulse until this was obliterated. The first useful
instrument, however, was devised by Marcy in 1876. He placed the hand in
a closed vessel containing water connected by tubing with a bottle for
raising the pressure and by another tube with a tambour and lever for
recording the size of the pulse waves. He maintained that when pressure
on the hand was made, the point where oscillations of the lever ceased
was the maximal pressure, the point where the oscillations of the
recording lever was largest, was the minimal pressure.
This pioneer work was practically forgotten for twenty-five years. It
was not until 1887 that V. Basch devised an instrument which was used to
some extent. This instrument recorded only maximum pressure. It
consisted of a small rubber bulb filled with water communicating with a
mercury manometer. The bulb was pressed on the radial artery until the
pulse below it was obliterated and the pressure then read off on the
column of mercury. V. Basch later substituted a spring manometer for the
mercury column. Potain modified the apparatus by using air in the bulb
with an aneroid barometer for recording the pressure. These instruments
are necessarily grossly inaccurate. Moreover, they do not record the
diastolic pressure.
In 1896 and 1897 further attempts were made to record blood pressure by
the introduction of a flat rubber bag encased in some nonyielding
material, which was placed around the upper arm. Riva-Rocci used silk,
while Hill and Barnard used leather. The latter used a bulb or Davidson
syringe to force air into the cuff around the arm and palpated the
radial artery at the wrist, noting the point of return of the pulse
after compression of the upper arm, and reading the pressure on a column
of mercury in a tube.
Except that the width of the cuff has been increased from 5 cm. to 12
cm., this is the general principle upon which all the blood pressure
instruments now in use are based. Most of the apparatuses make use of a
column of mercury in a U-tube to record the millimeters of pressure. As
the mercury is depressed in one arm to the same extent as it is raised
in the other arm the scale where readings are made is .5 cm. and the
divisions represent 2 mm. of mercury but are actually 1 mm. apart.
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