346 THE PULSE IN DISEASE. 



cease to act, from the resolute importunity of the phlebo- 

 tomist. 



The feeble pulse indicates debility, and the bloodless state, 

 and an oppressed pulse is usually found in pulmonary affec- 

 tions of an inflammatory type. The wiry pulse is generally 

 indicative of disease of the serous membranes, whereas the 

 intermittent and irregular form of pulse are associated with 

 special disorders, usually attended with danger to life. 



Venous pulse. This phenomenon is observed with great 

 facility in the jugular veins of animals. In some cases it is 

 not incompatible with health, whereas in others it is a valu- 

 able symptom of disease. The jugular or neck veins of an 

 ox are observed to pulsate or to fill at every heart-beat, when 

 the animal is lying and ruminating. In some instances an 

 appearance of venous pulse is produced by the pulsation of 

 the carotid artery producing the jerk in the jugular vein, 

 but at others the venous pulse is the result of the vein fill- 

 ing when the ventricles of the heart contract, and the auri- 

 culo-ventricular valves close suddenly. Delafond is unques- 

 tionably in error when he says that the venous pulse is due 

 to regurgitation of blood in the anterior vena cava, and the 

 jugular veins, when the right auricle contracts. He remarks 

 that he has observed the phenomenon on animals lying for a 

 long time during the performance of painful operations. It 

 is doubtful if, even in cases of heart disease, in which the pul- 

 sation of the neck veins is so manifest, there be any reflux of 

 blood. I believe not, and that the slow and embarrassed ac- 

 tion of the ventricle induces the momentary check to the 

 blood's flow in the veins whereby these fill with a jerk from 

 above. The reflux of blood, as far up as the venous pulse is 

 perceived, is impossible. 



