Diseases of the heart and arterial system : designed to be a practical presentation of the subject for the use of students and practitioners of medicine . ulse-wave were dividedinto two portions, of whichFig. bisferiens. the second is the stronger. Allbutts Syst. of Med., vol. v, mi , , J he former represents thesudden distention of the artery, and the latter is the palpable ex-pression of the praxlicrotic or tidal wave. Pulsus bisferiens is usu-ally stated to be found in aortic obstruction, but according toGraham Steell, cited by Clifford Allbutt, undoubtedly occurs insome cases
Diseases of the heart and arterial system : designed to be a practical presentation of the subject for the use of students and practitioners of medicine . ulse-wave were dividedinto two portions, of whichFig. bisferiens. the second is the stronger. Allbutts Syst. of Med., vol. v, mi , , J he former represents thesudden distention of the artery, and the latter is the palpable ex-pression of the praxlicrotic or tidal wave. Pulsus bisferiens is usu-ally stated to be found in aortic obstruction, but according toGraham Steell, cited by Clifford Allbutt, undoubtedly occurs insome cases of regurgitation associated with little if any one of Steells instances this peculiarity was not equally con-stant or pronounced on both sides of the body. Its production istherefore difficult of explanation, as well as inconstant. I havenever obtained a tracing showing a bisferiens pulse in aortic insuf-ficiency, but I have certainly felt pulses in some cases which, to myfinger, seemed plainly of this character. Not infrequently, pulsation is so pronounced in the arteriolesthat the fingers of the patient throb appreciably when grasped. AORTIC REGURGITATION .iO 1 and the diagnosis of his malady can be made while in the act ofshaking his hand. Two other phenomena, the capillary pulse and visible venouspulse, should properly have been described under inspection, buthave been reserved until now for the reason that they will be bet-ter understood after what has just been said concerning the pecu-liarities of the pulse. In cases in which arterial tension is verylow in consequence of free regurgitation, the capillaries are dis-tended by the blood-wave instead of being kept uniformly filled,and hence display what is known as the capillary pulse (Quinckessign). This may be well seen in the palm and beneath the nailswhen the hand is warm, or it may be evoked by friction of theskin—e. g., of the forehead—until an area of hyperemia is pro-duced. If the periphery of such a
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