This theory is open to many objections. First, there is no reason why
the blood wave should not produce a dicrotic elevation when it flows
back to the aorta. Second, the narrow lumen of the arterioles cannot
be an obstacle to the flowing blood, because if an artery splits up
into small branches, the sum of the lumina of the branches is greater
than the lumen of the artery. Lack of space, therefore, cannot be the
cause of the reflection of the pulse wave. Marey, finally, is mistaken
in his conception of the effect of the blood pumped into the aorta by
the action of the left ventricle. He supposes that the entering blood
pushes before it the whole column of blood in the arteries. This view
is refuted by the actual measurements of the velocity of the pulse
wave, because if it were true the pulse would appear at the same moment
in every part of the body.[48]
These are the more obvious of the arguments against Marey's theory.
Other investigators have tried to state a more correct theory of the
central origin of the dicrotic wave. Landois's theory belongs to this
type of improved theories of the central origin. The action of the
left ventricle, according to Landois, causes the primary pulse wave
which travels down the arterial system, until it is extinguished in
the arterioles. The walls of the arteries are expanded by the arriving
blood wave, and, when the valves close, they force the blood onward by
their elasticity. There is a free way to the periphery, but the blood
pushed towards the heart finds the semilunar valves closed and is
reflected. In this way a new positive wave originates which may produce
in the same way a secondary or tertiary wave.[49]
It seemed necessary first to decide between the theories of the central
and of the peripheral origin of the dicrotic wave. Many investigations
have been carried on for this purpose, and some of them bear witness
to the high ability of the investigators. It is, however, remarkable
that the arguments which have been brought forward in favor of one
hypothesis chiefly consist in reasons why the other hypothesis should
not be accepted. These experiments can be divided into two classes.
The first class comprises all the experiments which study the relation
of the pulse curve to other functions, or its dependence on various
conditions. The above mentioned observations of the pathological
changes of the pulse curve belong to this class. The object of frequent
studies of this type has been the relation of the sphygmographic
curve to the curve of the apex beat. The papers of Otto and Haas,[50]
Garrod,[51] Traube,[52] Rosenstein,[53]
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