The influences mentioned under (1) may be seen in tracings taken from
cases of cardiac insufficiency, and have merely pathological interest.
All the other influences, however, can be observed in the curves which
are traced for psychological purposes. The changes in the general rise
or fall of the curves are not so very hard to observe,[81] and for the
observation of the rapidity of the heart-beats it is only necessary to
trace a time-curve and count the number of beats or measure the length
of every single beat. Also the changes of the height of the waves can
easily be measured. This has been done conscientiously by several
observers. It is by far harder to see the changes in the form of the
catacrotic branch, and only a few keen observers have seen them. These
changes of the pulse curve under the influence of feelings were proved
as facts by experiments, but their interpretation was doubtful. With
the exception of the rapidity of the heart-beats, which could easily
be observed in some other way, all the symptoms of the influence of
feelings on circulation are ambiguous. A difference in height of the
single waves may be due to a change in the amount of blood which is
pumped into the artery, but it also may be due to a change in the
amplitude of the vibrations of the artery. The form of the catacrotic
part of the sphygmographic curve may be changed by a different state of
innervation of the arterial wall, but it also may be due to an increase
or decrease of the friction of the surrounding tissues. The general
rise or fall of the curve may indicate a change in the amount of blood
which leaves the left ventricle, but it also may indicate a change in
the amount of the capillary outflow.
The problem, nevertheless, is fully determined, and a solution is
suggested by the constructions in Fig. 5. The form of the resulting
movement depends, first, on the length of the line _AB_, secondly, on
the length of the line _AE_, and thirdly, on the nature of the elastic
movement. An elastic movement is determined if three constants are
known, one of which is the amplitude, the second the friction, and the
third the elasticity. Only _AB_ can be measured directly, and there
remain four unknown quantities to be determined. Four measurements
must be sufficient for this purpose. It is obvious, however, that not
any four measurements will do, but a method can be devised by which
it is possible to determine each one of these four quantities. The
problem can be solved in every case provided that the sphygmogram is
trustworthy enough to justify the work. The length _AB_ is proportional
to the time of one heart-beat, and the length of the line _AE_ is
proportional to the amount of blood pumped into the arteries. The
successful analysis of the pulse curves, therefore, shows changes of
the action of the heart and makes it possible to distinguish them from
the changes at the periphery.
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