( 1185 ) 
much It is, only to be applied to intelligent patients, and introduces 
the subjectivity of the patient instead of that of the investigator, 
which is at least as bad, and causes by exertion of the attention an 
increase of the blood-pressure. 
The auscultatory method (Kororkow) by which, distal from the 
armlet, an artery-tone is heard to become louder or softer in accord- 
ance with the different pressures prevailing in the armlet, so that 
in this way indications must be obtained for the determination of 
the MBp and the mfp is of course connected with the same draw- 
back of subjectivity. 
The same objections hold for Enret’s method, who feels the maximal 
oscillations and the disappearance of the pulse at the artery imme- 
diately below the lower edge of the armlet. 
None of these methods could therefore satisfy von RECKLINGHAUSEN, 
and he tried to find another. 
He fills the armlet with water and graphically registers the fluct- 
uations in it by a Hürrnre tonograph. On theoretic grounds he 
admits that if the pressure in the armlet = the pressure in the 
artery, the arterial wall moves freely, and the amplitude of the 
pulse-wave is correctly recorded by the tonograph. And at the same 
time he admits that, as at that moment the pressure in the armlet 
= the pressure in the artery, the height of the pulse-wave is conse- 
quently correctly recorded. Then he divides the pulse-curve into 
different parts and admits that where a definite part is recorded as 
greatest, its height is also correctly recorded. From a ‘“Treppencurve”’ 
obtained in this way, he construes then an absolute sphygmogram. 
SAHLI has given a sharp criticism of this long-winded method, 
which can be read in the D. Arch. f. Klin. Med. Bd. LXXX 1904, 
p. 493, and which we are not going to repeat in extenso. He proves 
that the friction during the passage of the pulse-wave under the 
— broad —- armlet and other factors are as many sources of errors. 
In his last publication von ReckLiINGHAUsHN maintains his method, 
especially because it gives the same figures for the pressure of the 
blood as the other methods (Beihefte zur Med. Klinik, Hft. 8, 1910). 
He forgets, however, that just those other methods are not sufficiently 
reliable on account of their subjectivity. 
However it may be, great discrepancy still prevails with regard 
to the problem of determining the pressure of the blood in man. 
All methods give us a somewhat unsatisfactory feeling. Moreover 
VON RecKLINGHAUSEN’s method is complicated, his apparatus is expen- 
sive and his reading of the curves not in every respect without 
objection. 
78 
Proceedings Royal Acad. Amsterdam. Vol. XIII. 
