5. A slow but tense pulse, such as occurs in the apoplectic, hydrocephalic, and malignant states of fever, in which its strokes are from 60 to 90, in a minute. 6. An uncommonly frequent pulse, without much tension, beating from 120 to 170 or 180 strokes in a minute. This state of the pulse occurs likewise in the malignant states of fever. 7. A soft pulse, without much frequency or fulness. I have met with this state of the pulse in affections of the brain, and in that state of pulmonary fever which is known by the name of pneumonia notha. It sometimes, I have remarked, becomes tense after bleeding. 8. An intermitting pulse. 9. A depressed pulse. 10. An imperceptible pulse. The slow, intermitting, depressed, and imperceptible states of the pulse are supposed exclusively to indicate congestion in the brain. But they are all, I believe, occasioned likewise by great excess of stimulus acting upon the heart and arteries. A pulse more tense in one arm than in the other, I have generally found to attend a morbid state of the brain. Much yet remains to be known of the signs of a disease in the brain, by the states of the pulse; hence Mr. Hunter has justly remarked, that "In inflammation of the brain, the pulse varies more than in inflammations of any other part; and perhaps we are led to judge of inflammation there, more from _other_ symptoms than the pulse[55]." [55] Treatise on Inflammation, chap. iii. 9. The slow, uncommonly frequent, intermitting, and imperceptible states of the pulse, which require bleeding, may be distinguished from the same states of the pulse, which arise from an exhausted state of the system, and that forbid bleeding, by the following marks: 1. They occur in the beginning of a fever. 2. They occur in the paroxysms of fevers which have remissions and exacerbations. 3. They sometimes occur after blood-letting, from causes formerly mentioned. 4. They sometimes occur, and continue during the whole course of an inflammation of the stomach and bowels. And, 5. They occur in relapses, after the crisis of a fever. The other states of the pulse indicate bleeding in every stage of fever, and in every condition of the system. I have taken notice, in another place, of the circumstances which render it proper in the advanced stage of chronic fever. If all the states of pulse which have been enumerated indicate bleeding, it must be an affecting consideration to reflect, how many lives have been lost, by physicians limiting the use of the lancet only to the tense or full pulse!