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ployed without a stand, as it must rest upon the 

 ribs, the elastic wall of the chamber should be 

 plain, and not protruding. 



The hand-sphygmoscope is an exceedingly 

 delicate instrument, but requires great care and 

 nicety in its construction. It may be made by 

 taking about an inch and a half of a gutta percha 

 tube, half an inch in diameter, slightly widening 

 one extremity of it to make a chamber large 

 enough to hold a small horse-bean, and fastening 

 with thread a piece of thin india-rubber, or of 

 Bourgeaud's india-rubber bandage, securely over 

 it for the elastic and moveable wall. The liquid is 

 now supplied, and the glass tube, with a very fine 

 flat bore, say -j\j-th of an inch, and provided with 

 a ring of india-rubber, obtained by cutting off a 

 small portion of a fine india-rubber tube, for a 

 "washer," is now inserted and the instrument is 

 ready for use. The hand-sphygmoscope discovers 

 the blood-wave in regurgitation of the jugular ^^ Sphygmo . 

 veins; it responds to the radial of the newly- scope. 



born infant ; it rises and falls with the movements of the brain of the 

 infant, though some months old, as that organ rises and falls under 

 the influence of its arteries. There is no doubt that, applied to the 

 fontanelles before delivery, it will inform the obstetrician whether 

 the foetus be dead or alive, and, in cases of difficult labour, supply 

 important evidence for his guidance. 



The hand-sphygmoscope applied to the radial artery, and to the 

 fontanelles of a dying infant three months old, has indicated to the 

 author the influence of respiration upon the circulation. During 

 inspiration, the column of liquid in the tube was found to fall as if 

 sucked down, and during expiration to spring again. 



In practical surgery, the hand-sphygmoscope may possibly be 

 employed with advantage, for it will rise with the wave or fluctuation 

 of liquid tumours. It may be placed where the fingers cannot reach. 

 The rise in the instrument is greater in liquid than in aeriform 

 tumours on account of the compressibility of air, and the fall is more 

 rapid and decided when the contents of the tumour are liquid. 



