« AnteriorContinua »
It is almost needless for me to observe, that every precauţion has been taken to avoid error. If, throughout the essay, this desirable object be attained, it is principally attributable to the assistance of my friend Dr. James Thomson, continued with unremitting zeal and friendship, during a course of experiments both tedious and delicate. *
SECTION I. 1st, When we recollect that it is during the course of the day that all those circumstances, which tend to accelerate the pulse, are generally combined and present, the proposition that the morning pulse of a person enjoying health is quicker than the evening one, must seem almost a paradox; at all events so hostile to what appears probable or plausible, that the clearest evidence of its truth must be brought forward before we could expect to gain a single proselyte.
In detailing the results of my observations and experiments on this subject, a certain degree of license is necessarily made use of, which, however, does not at all affect the conclusions I have drawn. In these experiments it is not proposed to submit the functions of the body to rigorous calculation. In physiology, as well as in medicine, a near approximation to the truth is the only rational end we can possibly propose. Numbers are used, both because they render our ideas more precise, and cause to be distinctly perceived the limits to which we should wish to extend these doctrines. The variation in different individuals must necessarily be immense;—for that the candid will make proper allowance.
Dr. Cullen, (whose name is not merely celebrated, but venerated in medical science,) talked of a natural acceleration of the pulse, which, according to him, happens twice a day, and resembles, in a distant manner, a febrile paroxysm. Now, amidst many hundred experiments, performed under a great variety of circumstances, I could never perceive any such phe
The subject of the experiments is about 22 years of age, of a moderate height, and somewhat muscular; his constitution may be called irritable,-by which is meant only, that it is easily excited by stimulants of almost every kind. He has not laboured under any serious disposition for a great number of years, nor is he conscious of any hereditary or acquired tendency to disease in any organ.
nomenon. The time of the day at which the first spontaneous acceleration is supposed to happen, is noon. My own pulse never shewed any symptoms of such acceleration, but, on the contrary, always diminished in velocity. Thus,
The other paroxysm, according to the same author, occurs in the afternoon, and that, too, totally independent of any excitement by food, &c. This opinion is equally erroneous with the former.
These experiments are in direct opposition to the statements of Cullen; yet, whoever carefully peruses that author's works, more anxious to discover truth, than, by partial views and misrepresentations, to detect contradictions, will be convinced that Cullen's notions are partly just, and partly erroneous; that delicate and accurate observation is blended throughout with supposition, assertion, and hypothesis.
2d, This quickness of the arterial pulsation, observable in the morning, is at present very generally disbelieved; yet nothing can be more easy than to ascertain the fact experimentally. Perhaps the following instances, taken at random from a great number of others, may go far to settle the point. In the following table the pulse was reckoned in the sitting posture, (this is always to be understood, unless the contrary be expressed) before breakfast, and a short time after rising from bed; and, in the evening, after a light supper, and generally
some spirituous liquor, taken, however, in small quantity, and much diluted. The power of alcohol in raising the pulse is well known. The period is the summer time.
To render the result of this table the more striking, it is necessary
for me to point out a few circumstances, to which considerable attention ought to be paid. In the morning, the pulse was reckoned immediately almost on rising from bed, and always before food of any kind was taken. Every circumstance, therefore, conspired to reduce the pulse. On the other hand, the evening pulse was reckoned, after the many exertions undergone during a long day,-after exercise of mind and body, after food and drink; the pulse is, notwithstanding, considerably less frequent than in the morning, when every thing favourable to the rapid state of the circulation was carefully guarded against. But the pulse is not only in general quicker in the morning than in the evening; it is also more excitable; i. e. the same quantity of food or drink, the same degree of exercise, shall be found to exalt the pulse more in the morning than at any other period of the day or night; and the capability of being excited may, generally speaking, be said to diminish from a very early hour until the same hour next morning. The data on which this assertion rests are pretty numerous, though not so complete as I could have wished them to be. To accomplish this, would have required a complete change of my mode of life, which I found at the time impracticable.
TABLE Showing the different states of the pulse, as reckoned at three
different periods of the day, viz. after breakfast, dinner, and supper. The experiment was made during summer. After breakfast, always After dinner, before Evening, between 10 before 10, A. M.
5, P. M.
and 12, P. M. generally
Average 74.22, &c. Average 64.388, &c.
The conclusions to be drawn from this table are obvious. To render them still more so, I may observe, that the breakfast is generally a moderate one, consisting of coffee, bread, and eggs; the dinner always of animal food principally, and a small quantity of vegetables; to which was often added a little spirits or porter; and, notwithstanding the vast difference between the stimulating powers of these two meals, the morning pulse is inferior to the one after dinner by only two beats; the difference would have been ten or fifteen, had the case been reversed, at least I am induced to think so from some experiments which I afterwards instituted directly to ascertain the point. In the evening the pulse was reckoned after supper, light, indeed, but certainly equal to the breakfast in stimulant power, and in some measure more so, because spirituous liquors very generally supplied the place of coffee. Notwithstanding, this, the evening pulse is found to be, on an average, nearly eight beats lower than the morning one; a difference by no means inconsiderable, and sufficiently warranting the conclusions I have drawn from it.
The following table was drawn up, in order to ascertain the effects which moderate exercise in the morning would produce on the pulse, reckoned, however, in such a manner as not to be immediately affected by it.
3. My experiments have not yet enabled me to ascertain, with precision, the hour when the pulse begins not only to be actually more rapid, but also to acquire a greater capability for action, manifested by the exhibition of any stimulant. This, with myself, perhaps takes place about 3 P. M. (A. M.?); but there is every reason to believe that the time varies with the individual, the season, climate; and perhaps, though this for many reasons is improbable, with the mode of life.
4. This increased capability for action, occurring regularly in the morning, is even of greater importance than the actual state of the circulation; the former may be made the subject of very delicate experiments; the latter we know to be exposed to a thousand variations, from causes which have been in part developed. While experimenting on this subject, there occurred to me a case, altogether of so interesting a nature, that I cannot refrain from giving it in detail. It affords a remarkable proof of the truth of the doctrines brought forward in this essay; at the same time, independent of this consideration, from the rarity of its occurrence, it appears to be worthy of record.