. Medical diagnosis for the student and practitioner. 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. 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 ini
. Medical diagnosis for the student and practitioner. 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. 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 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 One 73. o Two Three Four 83. o Five Six • Seven 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 occur. Accustomed effort of the same grade may cause a rise of only 10mm. or less. The rise of pre
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
