File:Medical diagnosis for the student and practitioner (1922) (14784152022).jpg

Identifier: medicaldiagnosi00gree (find matches)
Title: Medical diagnosis for the student and practitioner
Year: 1922 (1920s)
Authors: Greene, Charles Lyman, 1862-
Subjects: Diagnosis
Publisher: Philadelphia, Blakiston
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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Third Phase. —Asharp sound appears andgrows progressively moredistinct and louder dur-ing a recession of about 25mm. of the mercury in themanometer column. Fourth Phase.—Dias-tolic Pressure Level.—This represents theabrupt muffling of thetone of the preceding(third) phase and lastsfor only a short periodrepresented by a reces-sion of about 5 mm. ofmercury.The scale reading of the manometer at the exact time of the appearance ofthis dull muffled sound is taken as representing the diastolic pressure. Fifth Phase.—This is merely the period initiating entire loss of soundsand by Koratkow and others was considered formerly as representing thediastolic pressure point. The use of the fourth phase is probably the more accurate and certainlythe more generally applicable method inasmuch as complete disappearanceof sounds may not occur in aortic regurgitation or in certain cases of exoph-thalmic goiter. Normal Readings.—The normal systolic pressure readings according to A clear sound.
Text Appearing After Image:
Fig. 184.—The auscultation method. (A7orris.) Confused multiple bruits. Reappearanceand intensifi-cation of cleartone. Abruptmuffling oftone. 476 MEDICAL DIAGNOSIS Effect ofexcitement. A great need. Faulty figures, Results inpractice. Janeway are: for young adults, ioo to 130; older adults 100 to 145; children90 to no; infants under two years, 75 to 90.* Age.—The following table is that of L. Gordon, and represents the resultsof an extensive study of the relation of age in normal children to systolicblood-pressure. Years Mm. Hg. Under one 71.0 One 73. o Two 79.3 Three 81.0 Four 83. o Five 86.5 Six • 88.5 Seven 85.0 Eight 93. o Nine 100. o Ten 95. o Eleven 104. o Twelve 105. o Excitement may cause a rise of 40 mm. or more and physical effort a slightincrease or, if extreme or of an unusual nature and abrupt, a rise of 30-60 mm.may occur. Accustomed effort of the same grade may cause a rise of only 10mm. or less. The rise of pressure under exercise and excitement alike is predomin

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