The contradiction between the theories of the peripheral and of the
central origin of the dicrotic, however, is only apparent, and neither
may be true, because it might be that this elevation is not due to
a wave which travels in the blood. The experiments of the previous
investigators seem to point in this direction. The disappearance of the
secondary elevations when the arterial wall has lost the properties
of an elastic body, the above-mentioned experiments of v. Kries, and
the observations of Grashey and Marey on the movements of the walls
of an elastic tube indicate clearly that nothing but elasticity is
needed to produce these secondary or dicrotic elevations, for, in the
different experiments, they are produced as well when the heart and
its valves are replaced by a valveless bag as when the function of
the valves is unimpaired; as well with resistance at the periphery as
without, the only condition being that the walls are elastic. This
proves the importance of the elasticity of the arterial wall. The
experiments of the graphic registration of the movements of the walls
of an elastic tube, furthermore, indicate that the conditions of this
experiment are a close imitation of the mechanical conditions which
prevail in the arteries. It may be expected that the analysis of the
conditions of the experiment will give an insight into the origin of
the sphygmographic curves, because the tracings which Grashey and Marey
took from the walls of a rubber tube resemble closely the tracings of
the human pulse. This experiment, first, proves that the form of the
curve depends merely on physical conditions. The movement of a point
of the wall of the tube depends on the following four factors: (1) The
elasticity of the wall; (2) the incompressibility of the liquid; (3)
the form of the original wave, _i. e._, the way in which the liquid
is pumped into the tube; (4) the rate of outflow. If the process of
pressing liquid into the tube is repeated regularly, a stationary form
of movement will be obtained eventually; the amount of outflow for one
interval is constant in this case. This means that eventually a state
is attained where the same quantity of liquid which is pumped into the
tube at one end flows out from the tube at the other. The physiological
bearing of this result is that the turgor of an artery does not change
without a cause. Such a change would be indicated by the going up or
down of the base-line of the tracing.
The first two factors are, in physiology, studied with relative
ease. The elastic qualities of the arteries have been studied since
Poiseuille and John Hunter by Wertheim, Zwardemaaker, Marey, and
others, and they are more or less well known. The physical properties
of the blood are very nearly those of an incompressible liquid, and
this is certainly true for the small pressure to which the blood is
exposed in the arteries.
Public-domain text, read in full here on John Shaqi.
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