SECT. I.
Of the Pulse.
When we consider the admirably curious structure of the human mechanism, it must clearly appear, how easily the animal œconomy may become disordered. But so kind has the ALLWISE AUTHOR of our existence been to his creatures, that on the slightest indisposition, the whole system is sensible of the least disagreeable sensation; and every part, with a social and sympathetic friendship, is ready to relieve the fabric from whatever is obnoxious, and causes the disturbance.
As nothing has a greater share in life than the blood, so nothing likewise on the least indisposition, is sooner set in commotion, and gives the alarm, than this very liquor, in which life itself is contained; and the circulation of this fluid in the arteries, furnishes us with the greatest prognostic, namely, the pulse, by which we may, with any degree of certainty, judge of the state of the body, and foretell good or bad events. How beneficial it is then to be acquainted with this knowledge, I shall leave to every rational being to determine.
Every artery in the living body constitutes a pulse, as has been explained in Sect. V. in the foregoing lecture.
And it is demonstrative from simple reason, that the pulsation of such arteries must be in proportion to their magnitude, greatest in the heart, whence they take their origin; till the vibration must gradually be lost to the touch, as they become insensibly small, and lose themselves in their ramificatory capillary tubes.
The artery which is most convenient to our examination, is that which lays immediately to the touch on our wrist, below the thumb, on the radius, just below the knuckle of that bone; and it is there we are best able to distinguish the pulsation of the arteries, as being most exposed to the external touch; because it is immediately between the skin and the flat of that bone.
Thus much premised, we will first consider the pulse in the sound state; and next make a comparison with that in people labouring under diseases.
In a full grown man, in the vigour of health, the pulse ordinarily beats once to every second, that is, 60 times in a minute, 3600 in an hour, and 31,536,000 times in a year. It varies however in different subjects, according to the stature, temperament, condition, time, and action of the same; insomuch, that two persons equally in a good state of health, shall, however, differ widely in their pulses. Yet, notwithstanding, there are peculiar signs, which will ever make a true distinction between health and sickness; practice however is requisite to form a proper judgment of such distinction.
In order to lay a proper foundation to understand the nature of this great prognostic, I shall divide the pulse into the following classes:
1st. A full, slow, and regular pulse, denotes a perfect state of health; for whilst the blood moves regularly in the arteries, without pain to the nervous system, or disturbance to the animal œconomy, the pulse will beat precisely regular, without trembling, fluttering, hurry, distinction, or feebleness, and discover to the touch, a peculiar easiness; and this, every one, who wishes to become master of that subject, should carefully attend to.
2dly. A full and quick pulse, indicates a fever; for by the irritation of the nerves, the vibration of the arteries are accelerated. If a gentle perspiration attends it, it may be deemed salutary; and with this pulse it appears, that nature makes a vigorous effort to expel what is obnoxious: therefore in such a pulse, a gentle perspiration generally gives relief.
3dly. A full, quick, and hard pulse, denotes great irritability in the nerves, and a redundancy of blood; this is the pulse of a fever; and here bleeding, if timely applied, is very requisite, as also medicines which promote perspiration.
4thly. A small and quick pulse, denotes an irritability in the nervous system, and a contraction of the arteries; this is generally the pulse which attends sudden shocks and frights, as also in the cold fits of agues. The causes should carefully be attended to: if, from a sudden shock, bleeding is useful; but in the latter case, it is hurtful. It seldom lasts long, and a full feverish pulse generally follows, and the state of the patient ought here to be the guide: for, the same pulse may proceed from too great a plenty of blood, as well as from a deficiency; consequently requires different treatment; and this shall be pointed out more fully hereafter.
5thly. An irregular full pulse, is at all times a bad one; many may be the causes, and generally denotes a great confusion in the nervous system, and in the circulation of the blood. This pulse is generally the attendant on violent inflammations, phrenzy, delirium, &c. and if it continues any time, forebodes great danger: bleeding in time is greatly requisite, and other remedies, in order to assist the nerves, and bring the circulation to its proper regulation again.
6thly. An irregular small pulse, is frequently the attendant of an emaciated constitution, putrid fevers, and consumptions; and this dangerous pulse too generally forebodes the approach of death. The more irregular the pulse grows, small, weak, trembling, and leaves off by irregular intervals, the sooner dissolution is at hand; till at last, the pulse entirely disappears, and life ceases. But dangerous as this pulse is, yet it must be observed, that it often appears in the strongest constitutions, as in sudden emotions of the mind, falls, &c. or in a swooning. This is also the last and the first pulse in suffocations; or in other words, the struggling pulse between life and death.
These few distinctions of the pulse we will let suffice, as they, when properly attended to, will in all cases enable us to make a true distinction between health and the different stages of sickness, and accordingly direct us to a true method of cure.