. The clinical study of blood-pressure : a guide to the use of the sphygmomanometer in medical, surgical, and obstetrical practice, with a summary of the experimental and clinical facts relating to the blood-pressure in health and in disease . fect ofexertion, when measurements are made during deep laboredbreathing, they will be very evident. Especially must it beremembered, in comparing the effect of exercise and similarprocedures on the blood-pressure, when investigated with dif- VARIATIONS IN THE SAME INDIVIDUAL 113 ferent instruments, that neither the respiratory nor Traube-Hering curves a
. The clinical study of blood-pressure : a guide to the use of the sphygmomanometer in medical, surgical, and obstetrical practice, with a summary of the experimental and clinical facts relating to the blood-pressure in health and in disease . fect ofexertion, when measurements are made during deep laboredbreathing, they will be very evident. Especially must it beremembered, in comparing the effect of exercise and similarprocedures on the blood-pressure, when investigated with dif- VARIATIONS IN THE SAME INDIVIDUAL 113 ferent instruments, that neither the respiratory nor Traube-Hering curves affect systoHc and diastoHc pressure both cases, with the rise in mean pressure there is an in-crease in the size of the pulse-wave. This can be seen beauti-fully in the curves reproduced by Mosso (Fig. 34). It predi-cates a greater effect on systolic pressure than on diastolic, anda consequent divergence in results between the two types ofclinical instruments. Exact figures for the possible pressurevariations due to these causes are hard to give, but their extentin animals, combined with my observations on the changesnoted in patients from moment to moment, lead me to place30 mm. Hg. as the probable maximum rise which may be. Fia. 34.—Pekiodio fidotuations in the teaoino of blood-pkessdke taken feomDk. Colombo (while at best). (Mossos sphygm.) (From Mosso, Arch. Ital. de Biol., 1895, vol. xxiii, p. 192, Fig. 7.) attributed to them. One sees these larger fluctuations mainlyin patients with hypertension. Ordinarily, 5 to 10 mm. wouldbe a liberal estimate. A due appreciation of these facts makes some of the dis-crepancies in the findings of different observers intelligible. Ido not quite agree with Hensen that, in blood-pressure experi-ments, no conclusions must be drawn from changes of 10 or20 mm. Where a chart of the pressure, at intervals of a fewminutes, is kept for a considerable period before and after theprocedure to be investigated, small differences can be ac
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