100 ON DIGITALIS, WITH SOME OBSERVATIONS ON THE URINE. 

 Pia. 1. 6 P.M. — December 5. — Eight radial ; patient lying. 



"From this we see that the pulse is irregular and intermittent. The liffne 

 d'ensemhle, or line which wonld connect the tops and bases of each beat, instead 

 of being straiglit, is curved, showing that the arterial tension is more influenced 

 than usual by respiration. The pulse is dichrotic, this being especially marked 

 in the last pulsation on the tracing. This dichrotism is not perceptible, or only 

 to a very slight extent in subsequent tracings, showing that the tension of the 

 pulse, when the present tracing was taken was not only low in itself, but much 

 below the ordinary arterial tension of the patient.* He got 3 ozs. more brandy, 

 and a diaphoretic mixture (spt. ammon. aromaticus), which lessened the dim- 

 ness of vision. 



Fig. 2. December 0. — Tracing taken from right radial about 6 P.M. 

 Patient lying. 



The Ugne d^ensemhle is much more nearly straight than yesterday, showing 

 that the arterial tension is less variable. Pulse very slow, and irregular as to 

 time ; but while yesterday it was as it were a quick pulse with occasional inter- 

 missions, or peril aps it might be termed a quick pulse, becoming occasionally a 

 slow one, to-day it is a slow pulse with an interpolated beat or beats ; or a slow 

 pulse, becoming occasionally, and for a brief period, a quick one. 



The arterial tension is distinctly higher than yesterday, the line of ascent 

 being more blique, the top of the curve, instead of being sharp, is rounded, 

 and the line of descent gradual instead of sudden, and only the faintest trace of 

 dichrotism. 



Fig. 3. December 7. — Tracing taken from right radial at 1 p.m. Patient lying. 



The pulse is still irregular, and its characters are almost identical with that 

 of yesterday. We see the distinct interpolation of a beat in the case of the 

 pulsation h, which, if tbe line of descent prolonged to the same length as that 

 of a, would reach to the point d. If we join the bases a' and h' of the lines of 

 ascent of the waves a, h, and c, and prolong the line, we find that it passes 

 through the point d, and also that the distance between a' and h' is the same 

 as between h and d, showing that the rate of lowering of the arterial tension is 

 T,he same in both ; or, in other words, that the blood has been escaping with the 

 same degree of rapidity through the capillaries in both cases. So, when the 



* Comparing the suddenness with which the wave attains its maximum 

 height, and its sudden descent, with a tracing after recovery, we see that the 

 curdiac systole is very much more abrupt and shert than normally. 



