These secondary elevations were seen first by Chelius and Vierordt,
and from the beginning they aroused considerable interest. It was
known that sometimes during fever the pulse takes an abnormal form,
where two beats of the pulse, a strong one and a weaker one, may be
felt for every heart-beat (pulsus bis feriens). This form of the pulse
was thought to be entirely abnormal and it was therefore a great
surprise for the first modern investigators to find these secondary
elevations in tracings of the normal pulse curve. The conviction of
the abnormality of the dicrotic pulse form was so firm that Vierordt
always applied his instrument in such a way that it did not trace the
dicrotic elevation, although it was sensitive enough to trace the exact
form of the pulse curve. Marey, however, used his much more delicate
instrument and found the dicrotic elevation in most of the normal
pulse curves.[39] For this reason Marey's sphygmograph met at first
with considerable criticism (Meissner), but the critical examinations
by v. Wittich, Buisson, and Mach showed that the dicrotic elevation
could not be due to an error of the instrument, for so great an error
was out of question, and there no longer remained a doubt as to the
genuine existence of the dicrotic elevation in the normal pulse curve.
The sphygmograph, thus, had revealed two new and surprising features of
the pulse; (1) The ascent and the descent do not take place with equal
rapidity, the ascent being steep, the descent gradual;
(2) the descent is interrupted by secondary elevations. Neither of
these facts could be observed by applying the finger and it seemed
important to explain them. The explanation of the dicrotic promised to
be of special interest, as it was shown that abnormal dicrotism is in
close relation to the normal form of the pulse curve.
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