SPHYGMOMANOMETER AND ENDOCRINES 137 



In the minds of the laity and, for that matter, with a 

 large number of physicians, high blood pressure is the 

 only thing to be watched for, without realizing that a 

 hypotension for the age average, or a steadily falling 

 pressure of the blood, indicates an atonic state, a 

 toxemia, a concealed hemorrhage or some other grave 

 condition. They are also ignorant of the fact that 

 hypotension is of more common occurrence than hyper- 

 tension. 



BLOOD PRESSURE IN ACUTE INFECTIOUS DISEASES 



If we make a comparative study of the findings 

 accompanying acute infectious diseases, we find some 

 characteristics common to all, others common to many, 

 and were it not for the uncommon characteristics, we 

 could not distinguish many of these diseases from one 

 another. For instance, recall how many acute infec- 

 tions begin with a chill, followed by a fever, with the 

 rise and fall of temperature peculiar to the particular 

 disease. 



In most infections and also in most chronic condi- 

 tions (with a few exceptions which I will mention 

 later), we find an arterial hypotension. Usually, with 

 the onset of fever in acute infections, goes a temporary 

 rise of blood pressure. In some instances of infection 

 when I was called during the chill and had my sphyg- 

 momanometer with me, I have found the pressure to 

 be rising even then. Undoubtedly if we could be able 

 to secure reading more frequently at this stage, we 

 should find the blood pressure changes of much interest 

 and practical value. 



While the fever may keep up for days, within two or 

 three days after its onset, the blood pressure begins to 

 fall and continues to do this until it reaches a point 

 considerably below the normal for the patient's age. 



As an exception in infectious diseases, might be men- 

 tioned meningitis, in which hypertension is more often 



