ON PULSATION* IN THE JUGULAR AND 

 OTHER VEINS. 



(From the Medical Press and Circular, July 2ud, 1879.) 



Pulsation in the jugular veins is usually regarded as a sign of 

 tricuspid regurgitation, and therefore of grave import. When 

 I thus speak of pulsation in these veins, I of course exclude 

 the apparent pulsation produced by the motion communicated 

 to them by the pulsation of the carotids, and refer only to pul- 

 satile movements in the veins themselves. Several writers 

 have noticed that pulsations in the jugular veins may occur 

 without any cardiac lesion. Some have attributed these to con- 

 traction of the right auricle, while others have supposed them 

 to be caused by the aorta pressing the blood out of the intra- 

 thoracic veins into the jugulars during its distension by the 

 cardiac systole. Some observations which I have made upon 

 jugular pulsation have shown me that it is sometimes due to 

 the distension of the aorta acting in a somewhat different way 

 from that described by Friedrich. I cannot believe that the 

 phenomena I have observed have previously been unnoticed, 

 and I feel quite sure that they must have been already 

 described by older authors, although I have been unable to 

 find an account of them in more recent works. These 

 phenomena consist in apparent pulsation in the left jugular 

 alone, while it is absent from the right. In the first case of 

 this sort which I saw, the apparent pulsation was very marked 

 in the left jugular. On comparing it with the right, I noticed 

 that it also appeared to be much fuller ; and when I compressed 

 it just above the clavicle, in order to ascertain whether 1 could 

 thus stop the pulsation, it filled up very rapidly, and became 

 much distended. This showed that the peripheral vessels by 

 which it was supplied were much dilated, and that blood was 

 flowing very rapidly into it. On compressing the right jugular 



• This should rather be termed pseudo-pulsation. 



