76 METABOLISM AND GROWTH FROM BIRTH TO PUBERTY. 



better expressed than by quoting from the earliest report that we have 

 found in English of observations on the pulse-rate of children. 

 Publishing in 1694, Walter Harris of London stated: 



"But the Pulses of Children are naturally, or upon every little Alteration, 

 do become so swift and frequent, that they always seem somewhat Feverish. 

 Moreover, they are for the most part, so chagreen and froward, that not 

 keeping their Wrest one moment in the same posture, do not suffer their 

 Pulse to be touched. Lastly, there are so many things that do accelerate 

 or otherways change their Pulses, that Sentiments taken thence should 

 prove very uncertain, if not altogether false." l 



In the interesting book of Benjamin Waterhouse 2 we find a quo- 

 tation from a paper read in 1768 at the Royal College of Physicians 

 in London by the venerable Dr. Heberden: 



"The pulse of children under two years old should be felt when they are 

 asleep; for their pulses are greatly quickened by every new sensation, and 

 the occasions of these are perpetually happening to them while they are 

 awake. The pulse then of a healthy infant asleep on the day of its birth, 

 is between 130 and 140 in one minute; and the mean rate for the first 

 month is 120, for, during this time, the artery often beats as frequently 

 as it does the first day, and I have never found it beat slower than 108. 

 During the first year the limits may be fixed at 108 and 120. For the second 

 year at 90 and 108. For the third year at 80 and 100. The same will 

 very nearly serve for the fourth, fifth, and sixth years. In the seventh 

 year the pulsations will be sometimes so few as 72, though generally more; 

 and therefore, except only that they are more easily quickened by illness, 

 or any other cause, they will differ but little from the healthy pulse of an 

 adult, the range of which is from a little below 60 to a little above 80. It 

 must be remembered, that the pulse becomes more frequent, by ten or 

 twelve in a minute after a full meal." 



No further evidence as to the difficulties of making these physio- 

 logical records is necessary. Perhaps the best confirmation of this 

 evidence is the fact that so little is now known regarding the quiet 

 resting pulse of children. On looking over the literature on the 

 normal pulse-rate of children, it is at once obvious that very little 

 interest has been taken in the subject and few accurate counts have 

 been made which take into consideration all the factors which modify 

 the normal rate of the heart. It has been the custom of practically 

 all writers to report minimum and maximum pulse-rates and to follow 

 what seems to us the very confusing and entirely irrational procedure 

 of averaging these and reporting the result as the average pulse-rate. 

 A summation of our data shows that any pulse-rate above the minimum 

 is profoundly affected by the degree of activity; therefore, little, if 

 any, value can be placed upon observations of pulse-rate other than 

 those obtained with the child in repose. It is of importance to know 



1 Harris, An exact enquiry into, and cure ot the acute diseases of infants. London, 1694, p. 9. 



2 Waterhouse, An essay concerning tussis convulsiva or whooping cough, with observations on 



the diseases of children. Boston, 1822. 



