Diseases of the chest and the principles of physical diagnosis . haracteristically in aortic insufficiency. It isquick, collapsing and large in volume. The diastolic pressure is alwayslow (60 to 40 mm. Hg.), and the systolic pressure generally high (180 to140 mm. Hg.). Diastole is shortened and the height of the secondarywave is in direct proportion to the amount of arterio-sclerosis present,and not to that of the blood-pressure (Lewis). The Pulsus Paradoxus.—This term is applied to the disappearance orenfeeblement of the pulse during inspiration. It may occur normally: (1) During deep inspira
Diseases of the chest and the principles of physical diagnosis . haracteristically in aortic insufficiency. It isquick, collapsing and large in volume. The diastolic pressure is alwayslow (60 to 40 mm. Hg.), and the systolic pressure generally high (180 to140 mm. Hg.). Diastole is shortened and the height of the secondarywave is in direct proportion to the amount of arterio-sclerosis present,and not to that of the blood-pressure (Lewis). The Pulsus Paradoxus.—This term is applied to the disappearance orenfeeblement of the pulse during inspiration. It may occur normally: (1) During deep inspiration with glottis closed—negative intrathoracic pressure(Muellers experiment). (2) During forced expiration with closed glottis—highintrathoracic pressure (Valsalvas experiment). (3) If the breath is held after aforced inspiration—pressure on the subclavian artery—glottis open. (The musclesof shoulder girdle compress the subclavian arterv between the clavicle and the firstrib.) 1 Lewis, T.: Brit. Med. Jour., April 20, 1907. THE CIRCULATORY SYSTEM 161. The bigeminal pulse (digitalis effect in auricular fibrillation ion).
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