530 CIRCULATION OF BLOOD AND LYMPH. 



stiff arteries or stenosis of the semilunar valves. In the normal 

 individual an anacrotic pulse in the radial may be obtained, 

 according to von Kries,* by raising the arm. He believes that 

 in this position the reflection of the pulse wave from the periph- 



Fig. 215a. Photographic records of the subclavian (central) pulse and the radial (per- 

 ipheral) pulse. On the subclavian pulse, ab represents a wave due to auricular systole; be, a 

 small wave due to the rise of pressure in the ventricle before the opening of the semilunar 

 valves; cd marks the beginning of the ejection of blood into the aorta, de representing a wave 

 due to the vibration of the column of blood. At g the pressure falls suddenly at the beginning 

 of diastole or relaxation of the ventricle, giving the negative wave or incisura h; k, vibrations 

 corresponding to the closure of the semilunar valves and the second heart-sound. (From 

 Wiggers.) 



ery is favored, and that the anacrotic wave is simply a quickly 

 reflected wave. An opposite interpretation, however, is given 

 by von Recklinghausen, who states that conditions which lead 

 to a diminution in vascular tone and a dilation of the arteries 

 produce "weak reflection" and an anacrotic pulse. Constric- 

 tion of the small arteries in any system favors quick reflection 

 in the artery supplying the system and produces a pulse with a 

 sharp-pointed apex. 



Characteristics of the Pulse in Health and in Disease. 

 By mere palpation the physician obtains from the pulse valuable 

 indications concerning the heart and the circulation. The fre- 

 quency of the heart beat is at once made evident, so far at least as 

 the ventricle is concerned. One may determine readily whether 

 the frequency is above or below the normal, whether the rhythm 



* Von Kries, "Studien zur Pulslehre," 1892. 



