AND BLOOD PRESSURE 127 



in several active men, eminent in their walk of life and carrying some 

 60 years. Oliver gives armlet systolic readings of 135 in a man of 100 

 years, and 185 to 190 in a woman of 96 years, and says : " In women 

 the pressures are generally 5 to 10 per cent, less than in men." 



M'Cay of Calcutta says the pressure there varied between 

 83 and 118, and the average of a large number of observations 

 was slightly over 100 mm. Hg (sitting position, arm level with 

 heart). The low pressure there he attributes to the hot climate 

 relaxing the cutaneous vessels. In the standing posture the 

 arterial pressure is no lower, and may be higher, than in the hori- 

 zontal posture, and this without more than 5 to 10 extra pulse 

 beats a minute. In exhausted states the frequency of the heart 

 may be 30 or 40 more in the standing posture, and yet the pressure 

 be lower than in the horizontal position. The change of pulse 

 frequency with posture is an excellent test of the vaso-motor tone. 



The diastolic pressure in the small arteries, such as the 

 phalangeal, has been measured by G. Oliver by applying a small 

 bag (2-5 cm. X 9 cm.) round the third phalanx of the middle or 

 ring finger or the second phalanx of the thumb, and raising the 

 pressure till the maximal pulsation is obtained and felt by the 

 patient. To obtain the systolic pressure the finger is rendered 

 bloodless by squeezing a stout rubber ring over it as far as the 

 lower edge of the bag ; the pressure in the bag is then raised to over 

 100 mm. Hg, the ring removed, and the pressure lowered till the 

 bloodless finger suddenly flushes (Gartner). The lower range of 



j- i i. j i f\r 66-70 S ,, ,. , 80-90 S 



readings so obtained by Oliver are 45 _ 50 D , the higher fin _ 70 ,) 



On the arm, he says, there is no difference in pressure between 

 the brachial and radial arteries, but the pressure in the phalangeal 

 artery at the level of the first phalanx is 10 to 25 mm. less, and at 

 the level of the third phalanx the pressure is a little less than half 

 that in the big arteries. Thus the fall is unnoticeable in the big, 

 and rapid in the small arteries. In the latter too the systolic and 

 diastolic pressure approximate more and more. The ingestion of 

 food, according to Oliver, raises the arterial pressure in the distal 

 area ; the pressure in the last phalanx rises 15 to 20 mm. Hg 

 within an hour of taking food, and then slowly sinks down again. 

 Exercise raises the arterial pressure. In athletes immediately after 

 races the writer found systolic pressures of 140 to 220 mm. Hg. 

 The pressure falls markedly with over exhaustion. Thus after four 



