. A practical treatise on medical diagnosis for students and physicians . er and the elbow, the pressure is raised bycompressing the bulb until the radial pulse can no longer be felt, whenthe height of the column of mercury in the manometer will representthe pressure necessary to overcome the pressure of the blood in theartery, or, in other words, the blood-pressure. The reading can also be BLOOD-PRESSURE AS A FACTOR IN DIAGNOSIS. 415 taken by first causing the pulse to disappear and allowing the air toescape through a short branch-tube, provided for the purpose and con -trolled by a pinch-coc
. A practical treatise on medical diagnosis for students and physicians . er and the elbow, the pressure is raised bycompressing the bulb until the radial pulse can no longer be felt, whenthe height of the column of mercury in the manometer will representthe pressure necessary to overcome the pressure of the blood in theartery, or, in other words, the blood-pressure. The reading can also be BLOOD-PRESSURE AS A FACTOR IN DIAGNOSIS. 415 taken by first causing the pulse to disappear and allowing the air toescape through a short branch-tube, provided for the purpose and con -trolled by a pinch-cock, until the pulse reappears at the wrist, when thenumber of millimetres of mercury is read off as before. As the onlypersonal factor involved in this procedure is the observers ability todetect a more or less feeble pulse, the results are fairly accurate; thedisadvantages of the instrument are that it is cumbersome, and that theobservation requires some little time and some preparation of the patient,as the arm-piece must be applied to the bared limb. The inventor has. Cooks modification of the Riva-Rocci sphygmomanometer. had a number of imitators, who have made more or less useful changesin the original apparatus, a modification of which is now on the marketin this country. There is also a portable form, which, however, suffersfrom the serious disadvantage that the jointed glass manometer is easilybroken. A very good instrument can be constructed by any one havingthe necessary manual skill with the ordinary appliances available in anyclinical laboratory. An instrument that is much used in Germany is Gartners tonometer,which is constructed on a somewhat different principle. Instead of com-pressing the trunk of the artery at some point proximal to the radialpulse, the finger is compressed by means of a pneumatic ring, the tissueshaving first been rendered bloodless by slipping a tightly fitting circularrubber band over the tip of the finger. The reading is taken at themoment w
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