DOMESTIC ECONOMY, HYGIENE, DIETETICS. 



377 



The condition of the pulse depends mainly on 

 two factors, each of which may vary inde- 

 pendently of the other : First, the contraction 

 of the heart, which propels the stream of 

 blood along the artery ; and, second, the re- 

 sistance in the small arteries and capillaries, 

 which controls the rate at which it leaves the 

 artery. The first determines the frequency 

 and rhythm of the pulse and the force of the 

 beats ; but the tension of the artery between 

 them and their apparent duration depends 

 mainly upon the peripheral resistance. " Feel- 

 ing the pulse," therefore, gives important in- 

 formation besides the rate of the heart's action, 

 and implies much more than the mere count- 

 ing of pulsations. Dr. Broadbent says : "A 

 complete account of the pulse should specify 



(1) the frequency i. e., the number of beats 

 per minute, with a note of any irregularity or 

 intermission or instability of the rhythm ; 



(2) the size of the vessel ; (3) the degree of 

 distention of the artery between the beats ; 



(4) the character of the pulsation whether 

 its access is sudden or gradual, its duration 

 short or long, its subsidence abrupt or slow, 

 note being taken of dicrotism, when present; 



(5) the force or strength of both the constant 

 and variable pressure within the artery, as 

 measured by its compressibility ; (6) the state 

 of the arterial walls.'' 



The frequency of the pulse varies with age, 

 from 130 to 140 per minute at birth to 70 to 

 75 in adult males, and with sex, being six or 

 eight beats more in adult females. In some 

 individuals it deviates considerably from this 

 standard, and may even be habitually below 

 forty or above ninety without any signs of dis- 

 ease. Ifc is increased by exertion or excite- 

 ment, by food or stimulants, diminished in a 

 lying posture or during sleep. In disease 

 (acute hydrocephalus, for example), the pulse 

 may reach 150 or even 200 beats; or, on the 

 other hand (as in apoplexy and in certain or- 

 ganic affections of the heart, it may be as slow 

 as between 30 and 20. 



The normal regular rhythm of the pulse 

 may be interfered with either by the occa- 

 sional dropping of a beat (intermission), or by 

 variations in the force of successive beats, and 

 in the length of the intervals separating them 

 (irregularity). These varieties often occur in 

 the same person, but they may exist independ- 

 ently of each other. Irregularity of the pulse 

 is natural to some persons ; in others it is the 

 mere result of debility ; but it may be caused 

 by the most serious disorders, as by disease of 

 the brain, or by organic disease of the heart. 



The other qualities of the pulse are much 

 more difficult to recognize though of no less 

 importance. The degree of tension or resist- 



ance to compression by the fingers varies 

 greatly : in a soft or low tension " pulse the 

 artery may be almost imperceptible between 

 the beats ; in a hard or " high tension " pulse 

 it may be almost incompressible. An unduly 

 soft pulse is usually an indication of debility ; 

 an unduly hard one is most often characteristic 

 of disease of the kidneys and gout. But the 

 tension, like the frequency of the pulse, under- 

 goes considerable variations in health from 

 temporary causes, and may in certain individ- 

 uals be habitually above or btlow the average 

 without actual disease. 



The force of the beats is a measure of the 

 vigor and efficiency of the heart's action. A 

 strong pulse is correctly regarded as a sign of 

 a vigorous state of the system ; it may, how- 

 ever, arise from hypertrophy of the left ven- 

 tricle of the heart, and remain as a persistent 

 symptom even when the general powers are 

 failing. As strength of the pulse usually in- 

 dicates vigor, so weakness of the pulse in- 

 dicates debility. Various expressive adjectives 

 have been attached to special conditions of the 

 pulse, into the consideration of which our 

 space will not permit us to enter. Thus, we 

 read of the jerking pulse, the hobbling pulse, 

 the corded pulse, the wiry pulse, the thrilling 

 pulse, the rebounding pulse, etc. The full 

 significance of changes of the pulse in disease 

 can only be appreciated by considering them 

 in connection with the other signs and symp- 

 toms of the case. 



Average frequ&icy at different ages in 

 health. 



AGES : BEATS PEE MINUTE : 



In the foetus in utero. between 150 and 140 



Newborn infants between 140 and 120 



During the first year from 130 down to 115 



During the second year from 150 down to 100 



During the third year from 105 down to 95 



From 7th to 14th year v . . from 90 down to 80 



From 14th to 21st year .'. . .from 85 down to 75 



From 21st to 60th year from 75 down to 70 



In old age between 75 and 70 



Co-Relation of Pulse and Tempera- 

 ture. As a general rule the co-relation of 

 pulse and temperature may be stated as fol- 

 lows, namely : 



An increase of temperature of one degree 

 above 98 F. corresponds with an increase of 

 ten beats of the pulse per minute, as in the 

 following table : 

 Temperature of 



99 

 100 

 101 

 102 

 103 

 104 

 105 

 106 



corresponds with a pulse of 60 

 70 



90 

 100 

 110 

 120 

 130 

 140 



Thermometry. In children the temper- 

 ature is normally one or two degrees higher 

 than in adults. 



