At this point a theory must be mentioned, which was brought forward
recently, because it is based on measurements of the velocity of
propagation of the dicrotic wave. This theory is connected with Krehl's
theory of the function of the valves. The blood, according to Krehl,
enters the aorta through a small opening, and expanding in a large
space it produces fluctuations and eddies, which would close the valves
if they were not kept open by the blood which streams through under
high pressure. They must, therefore, close at the moment when the
aortic pressure is equal to the intraventricular pressure. This occurs
shortly after the moment indicated by the beginning of the decline of
the intraventricular pressure curve. Now the second sound of the heart
is heard somewhere in the descending part of the cardiogram[71] and
the measurements of Huerthle[72] have shown that the second sound is
heard 0.02" after the beginning of the descent of the cardiogram. This
seems to indicate that the second sound of the heart is in a temporal
relation to the closure of the valves. Many theories of the origin of
the sounds of the heart agree on this one point that the second sound
is due to a noise in the muscles. It therefore may be supposed that
the second sound is due to the tension of the valves when they close
or shortly afterwards. The problem now would seem to be to find an
elevation in the descending branch of the curve of intraventricular
pressure, or in the tracings of the apex beat, which could be
attributed to the closure of the valves. It was taken for granted that
the curves of intraventricular pressure and those of the apex beat
were identical. In many of these tracings an elevation was found which
may be called "the wave _f_." This elevation is not found in all the
tracings, and its position seems to be rather variable. Edgren[73]
remarks that the wave _f_ was always found near the abscissa no matter
whether the preceding decline of the curve was great or small. In some
of Chauveau's tracings the wave _f_ is missing or indistinct,[74] in
others it is very well marked and approximately in the middle of the
descending branch of the curve.[75]
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