Harvard Psychological Studies, Volume 2

by Unknown

It certainly is a long step from this vague statement to Mosso's experimental investigations. His new instruments, the plethysmograph, and the balance, enabled him to study the distribution of the blood,[32] and he observed the influence of mental phenomena on the circulation,[33] on the bladder,[34] and on the temperature of the brain.[35] His work, "La Paura," describes the physiological effects of emotions somewhat in detail.

The way toward applying the method of expression to the study of emotions was shown by the results of previous physiological investigations. Casual observations of the influence of certain sense-stimuli on respiration and circulation were made by Naumann, Couty and Charpentier, Thanhoffer, Dogiel, Gley, Mays, Istomanow and Tarchanoff, Féré, Delabarre, and others.[36] The changes of breathing seem to be of greater importance, and some writers account breathing the most delicate physiological index of feelings.[37] It seems, however, that a satisfactory treatment can be obtained only by direct comparison of the respiration and circulation, and it now but seldom occurs that circulation is observed exclusively.

There are three different instruments for observing the circulation: the plethysmograph, the sphygmomanometer, and the sphygmograph. Each of these instruments allows one to observe a different feature of the circulation. The sphygmomanometer records the pressure in the artery; the plethysmograph records the volume of a certain part of the body; and the sphygmograph records the movement of a certain part of the arterial wall. The curves traced with the sphygmograph indicate to a certain extent the pressure of the blood, and sometimes they are called curves of blood-pressure to distinguish them from the plethysmographic curves which are called curves of pulse-volume.

The invention of these instruments is due to physiological investigations of the pulse. The problem of studying the pulse by graphic, or at least experimental methods, begins with the investigations of Hales and Poiseuille. The first great success in this line was the construction of the "Kymographion" of Ludwig, but this instrument had the disadvantage that it could be applied only by scission of an artery. This circumstance, of course, confined the application of the instrument to the study of the pulse of animals. After several attempts by Hérisson, Chelius, and others, Vierordt succeeded in constructing his sphygmograph, by which curves of the normal human pulse could be obtained. Some years afterwards Marey constructed his much more sensitive instrument, which was made still handier by the use of air transmission. Buisson was the first to use air transmission for sphygmography, but Upham had used it before for similar purposes. A considerable number of sphygmographs has been constructed since, and though they may show some improvements in detail, the technique of the sphygmograph has made no marked progress since Marey, and his instrument has been found by experimental tests remarkably exact.

The curves traced with the sphygmograph are extremely variable in shape and size. In almost every normal curve, however, a steep ascent may be seen; it is called the up-stroke or percussion stroke, and this part of the sphygmographic curve has the name of the anacrotic phase. This line of ascent ends abruptly and within the limits of the usual speed of the recording drum it goes over into the descent by a sharp angle. The descending part of the curve is called the catacrotic phase. The descent is not so abrupt and is not a more or less straight line, but is interrupted by secondary elevations. The first secondary elevation is the largest and is called the dicrotic.[38]

These secondary elevations were seen first by Chelius and Vierordt, and from the beginning they aroused considerable interest. It was known that sometimes during fever the pulse takes an abnormal form, where two beats of the pulse, a strong one and a weaker one, may be felt for every heart-beat (pulsus bis feriens). This form of the pulse was thought to be entirely abnormal and it was therefore a great surprise for the first modern investigators to find these secondary elevations in tracings of the normal pulse curve. The conviction of the abnormality of the dicrotic pulse form was so firm that Vierordt always applied his instrument in such a way that it did not trace the dicrotic elevation, although it was sensitive enough to trace the exact form of the pulse curve. Marey, however, used his much more delicate instrument and found the dicrotic elevation in most of the normal pulse curves.[39] For this reason Marey's sphygmograph met at first with considerable criticism (Meissner), but the critical examinations by v. Wittich, Buisson, and Mach showed that the dicrotic elevation could not be due to an error of the instrument, for so great an error was out of question, and there no longer remained a doubt as to the genuine existence of the dicrotic elevation in the normal pulse curve. The sphygmograph, thus, had revealed two new and surprising features of the pulse; (1) The ascent and the descent do not take place with equal rapidity, the ascent being steep, the descent gradual;

(2) the descent is interrupted by secondary elevations. Neither of these facts could be observed by applying the finger and it seemed important to explain them. The explanation of the dicrotic promised to be of special interest, as it was shown that abnormal dicrotism is in close relation to the normal form of the pulse curve.

This caused considerable interest in the observation of the pulse, and the sphygmograph was supposed to be of the greatest importance for medical diagnosis. Burdon Sanderson,[40] Landois, Lorain,[41] Ozanam,[42] Pfungen,[43] Riegel,[44] Roy and Adami,[45] and others have studied the sphygmographic curve under abnormal conditions, and wellnigh all diseases have been studied by these observers with the sphygmograph. The results were ambiguous and did not seem to justify the amount of work spent on these observations. The enthusiasm for the sphygmograph subsided, and it was no longer expected to obtain a diagnosis, or even, indeed, a prognosis of a disease from mere inspection of a pulse curve. Later investigators, in fact, confined their research to the proof of the ambiguity of the sphygmograms, which could be valuable only in connection with other observations. It could not be hoped that an explanation of the abnormalities of the pulse curve would be found before an understanding of the normal form was attained. It, therefore, seemed necessary to decide between two theories of the origin of the normal pulse curve, which had opposed each other almost since the discovery of the existence of the dicrotic elevation. Both theories chiefly refer to the origin of the dicrotic, and they agree on this, that the dicrotic elevation is due to a wave travelling in the blood, but they disagree on the direction in which this wave is moving. These two theories may be called the theory of the peripheral, and the theory of the central origin of the dicrotic wave.

The theory of the peripheral origin of the dicrotic wave assumes that the change of pressure which is indicated by the dicrotic elevation originates somewhere at the periphery and travels through the arteries towards the heart.[46] Commonly it is assumed that the dicrotic originates in the arterioles. This theory has been mentioned first, because it is the simpler in every respect, though the less probable. The origin of the dicrotic wave according to this theory is similar to the origin of the echo.