﻿436 
  

  

  Dr. 
  C. 
  H. 
  Jones 
  on 
  Reversed 
  Tracings. 
  

  

  [May 
  27, 
  

  

  II. 
  "Note 
  on 
  Reversed 
  Tracings." 
  By 
  C. 
  Handheld 
  Jones, 
  

   M.B. 
  Cantab., 
  F.R.S. 
  Received 
  March 
  22, 
  1875. 
  

  

  Soon 
  after 
  I 
  began 
  to 
  use 
  the 
  sphygmograph 
  I 
  was 
  advised 
  by 
  a 
  

   friend 
  to 
  have 
  the 
  spring 
  (which 
  only 
  gave 
  a 
  pressure 
  up 
  to 
  200 
  grammes) 
  

   changed 
  for 
  one 
  which 
  was 
  capable 
  of 
  giving 
  400. 
  While 
  working 
  with 
  

   this 
  one 
  day 
  I 
  obtained 
  from 
  the 
  pulse 
  of 
  a 
  healthy 
  man, 
  set. 
  52, 
  the 
  

   tracing 
  shown 
  in 
  fig. 
  I., 
  the 
  pressure 
  employed 
  being 
  384 
  grammes. 
  It 
  

   is 
  evidently 
  quite 
  an 
  ordinary 
  tracing 
  of 
  a 
  normal 
  pulse, 
  except 
  that 
  it 
  is 
  

   reversed. 
  If 
  the 
  glass 
  is 
  turned 
  round 
  and 
  viewed 
  from 
  the 
  non-smoked 
  

   side 
  the 
  tracing 
  is 
  all 
  en 
  regie 
  ; 
  but 
  viewed 
  from 
  the 
  side 
  on 
  which 
  it 
  was 
  

   drawn 
  it 
  is 
  topsy-turvy 
  sideways, 
  if 
  such 
  a 
  phrase 
  be 
  permissible. 
  I 
  

   could 
  not 
  comprehend 
  it, 
  and 
  showed 
  it 
  to 
  a 
  friend 
  more 
  versed 
  in 
  

   sphygmography 
  than 
  I 
  was 
  then 
  ; 
  but 
  he 
  could 
  only 
  say 
  that 
  I 
  must 
  have 
  

   made 
  some 
  strange 
  mistake. 
  Other 
  good 
  observers 
  thought 
  the 
  tracings 
  

   " 
  very 
  extraordinary," 
  but 
  could 
  give 
  no 
  explanation 
  of 
  their 
  raison 
  

   d'etre." 
  Not 
  seeing 
  how 
  I 
  could 
  have 
  erred, 
  I 
  varnished 
  my 
  slide 
  and 
  put 
  

   it 
  by, 
  in 
  the 
  hope 
  that 
  I 
  might 
  get 
  to 
  understand 
  it 
  some 
  day. 
  I 
  noted, 
  

   however, 
  the 
  fact 
  that 
  the 
  pressure 
  was 
  very 
  high, 
  viz. 
  384 
  grammes. 
  

   The 
  pressure 
  I 
  usually 
  employ 
  for 
  average 
  pulses 
  is 
  84 
  grammes 
  to 
  140. 
  

   Continuing 
  to 
  make 
  observations, 
  I 
  noticed 
  occasionally 
  that 
  the 
  lever, 
  

   when 
  moving, 
  behaved 
  in 
  an 
  unusual 
  manner 
  ; 
  instead 
  of 
  jerking 
  up- 
  

   wards, 
  it 
  jerked 
  downwards, 
  while 
  the 
  elevation 
  was 
  gradual 
  ; 
  aud 
  this 
  

   behaviour 
  I 
  found 
  was 
  connected 
  with 
  reversed 
  tracings 
  like 
  my 
  first. 
  

   One 
  of 
  these 
  observations 
  was 
  made 
  on 
  a 
  young 
  man 
  to 
  show 
  the 
  effect 
  of 
  

   exertion 
  (see 
  fig. 
  II.). 
  The 
  tracing 
  taken 
  before 
  exercise, 
  a 
  hard 
  run, 
  is 
  

   pretty 
  ample, 
  and 
  in 
  other 
  respects 
  normal 
  ; 
  it 
  is 
  marked 
  a. 
  The 
  two 
  

   next 
  tracings, 
  b 
  and 
  c, 
  were 
  taken 
  immediately 
  after 
  the 
  run, 
  with 
  the 
  

   same 
  pressure, 
  viz. 
  140 
  grammes, 
  as 
  employed 
  for 
  a 
  ; 
  they 
  are 
  both 
  

   reversed, 
  but 
  the 
  notch 
  is 
  hardly 
  apparent 
  in 
  c. 
  The 
  pressure 
  was 
  now 
  

   weakened 
  to 
  84 
  grammes, 
  and 
  tracing 
  cl 
  taken, 
  which 
  is 
  described 
  nor- 
  

   mally, 
  but, 
  like 
  b 
  and 
  c, 
  is 
  far 
  less 
  ample 
  than 
  a. 
  The 
  reduction 
  in 
  

   size 
  of 
  the 
  tracing 
  in 
  the 
  three 
  latter 
  observations 
  is 
  undoubtedly 
  due 
  to 
  

   cardiac 
  exhaustion, 
  and 
  may 
  be 
  noticed 
  in 
  several 
  of 
  the 
  instances 
  given 
  

   in 
  my 
  paper 
  in 
  the 
  Proceedings 
  of 
  the 
  Royal 
  Society, 
  1873 
  (vol. 
  xxi. 
  

   pp. 
  374-383). 
  But 
  the 
  reversal 
  of 
  the 
  tracing 
  in 
  b 
  and 
  c 
  seems 
  as 
  

   if 
  it 
  must 
  be 
  attributed 
  mainly 
  to 
  the 
  employment 
  of 
  a 
  pressure 
  which 
  

   had 
  become 
  excessive 
  in 
  relation 
  to 
  the 
  s} 
  r 
  stolic 
  force. 
  As 
  soon 
  as 
  this 
  

   was 
  lessened, 
  the 
  tracing 
  assumed 
  its 
  proper 
  form. 
  

  

  The 
  evidence 
  of 
  fig. 
  III. 
  is 
  to 
  the 
  same 
  effect. 
  It 
  represents 
  two 
  tracings 
  

   taken 
  by 
  Mr. 
  Hawksley 
  of 
  his 
  own 
  pulse, 
  while 
  I 
  was 
  present, 
  with 
  a 
  

   strong 
  -springed 
  instrument. 
  The 
  upper 
  (a) 
  was 
  taken 
  with 
  a 
  pressure 
  

   of 
  300 
  grammes, 
  the 
  lower 
  (b), 
  which 
  is 
  reversed, 
  with 
  750 
  gramme3. 
  

   The 
  notch 
  is 
  quite 
  as 
  marked 
  in 
  the 
  second 
  as 
  in 
  the 
  first. 
  But 
  it 
  is 
  cer- 
  

   tain 
  that 
  excessive 
  pressure 
  does 
  not 
  always 
  produce 
  a 
  reversed 
  tracing, 
  

  

  