Many things having reference to the arteries farther illustrate
and confirm this truth. Why does not the pulmonary vein pulsate,
seeing that it is numbered among the arteries? Or wherefore is
there a pulse in the pulmonary artery? Because the pulse of the
arteries is derived from the impulse of the blood. Why does an
artery differ so much from a vein in the thickness and strength
of its coats? Because it sustains the shock of the impelling
heart and streaming blood. Hence, as perfect nature does nothing
in vain, and suffices under all circumstances, we find that the
nearer the arteries are to the heart, the more do they differ
from the veins in structure; here they are both stronger and more
ligamentous, whilst in extreme parts of the body, such as the
feet and hands, the brain, the mesentery, and the testicles, the
two orders of vessels are so much alike that it is impossible to
distinguish between them with the eye. Now this is for the
following very sufficient reasons: the more remote the vessels
are from the heart, with so much the less force are they
distended by the stroke of the heart, which is broken by the
great distance at which it is given. Add to this that the impulse
of the heart exerted upon the mass of blood, which must needs
fill the trunks and branches of the arteries, is diverted,
divided, as it were, and diminished at every subdivision, so that
the ultimate capillary divisions of the arteries look like veins,
and this not merely in constitution, but in function. They have
either no perceptible pulse, or they rarely exhibit one, and
never except where the heart beats more violently than usual, or
at a part where the minute vessel is more dilated or open than
elsewhere. It, therefore, happens that at times we are aware of a
pulse in the teeth, in inflammatory tumours, and in the fingers;
at another time we feel nothing of the sort. By this single
symptom I have ascertained for certain that young persons whose
pulses are naturally rapid were labouring under fever; and in
like manner, on compressing the fingers in youthful and delicate
subjects during a febrile paroxysm, I have readily perceived the
pulse there. On the other hand, when the heart pulsates more
languidly, it is often impossible to feel the pulse not merely in
the fingers, but the wrist, and even at the temple, as in persons
afflicted with lipothymiae asphyxia, or hysterical symptoms, and
in the debilitated and moribund.
Here surgeons are to be advised that, when the blood escapes with
force in the amputation of limbs, in the removal of tumours, and
in wounds, it constantly comes from an artery; not always indeed
per saltum, because the smaller arteries do not pulsate,
especially if a tourniquet has been applied.
Public-domain text, read in full here on John Shaqi.
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