Abbildungen der Seite
PDF
EPUB

is not constant; and also, that there may be considerable fluctuation in the morning as well as in the evening.

Another series designed to ascertain the effect of fasting upon the pulse, and which was protracted during a space of thirteen hours, showed a diminution of six beats, with “occasional fluctuations."

The next observations were made to institute a more exact comparison between the state of the pulse in the morning and evening, by examining it in the morning and evening under precisely the same circumstances. A set of observations consisting of eleven series was first made, to try the effect of continued rest on the morning and evening pulse. A second set, consisting of fourteen series was made, to try the effect of food on the same.

In regard to the first, the plan adopted was to ascertain its frequency before breakfast, as a standard of comparison throughout the day. Breakfast was then taken ; and waiting until the pulse had subsided, from the increased frequency produced by the meal, to what it was before breakfast, it was counted every quarter of an hour, for a period varying in different series, from half an hour to two hours; and the mean frequency of the whole was noted. , The minimum frequency was also noted. Remaining after dinner then in a state of rest, until the pulse had acquired the same frequency which it had before breakfast, (which was generally about eight or nine in the evening,) tea was taken, consisting of exactly the same with the breakfast, and the observations made as in the morning. The results also were noted as before. This was repeated eleven days, and a table constructed, containing the results of each day. The following is given by Dr. Guy, as " the mean results of the series given in the table.”

9

maz.

[ocr errors]

maz.

mean

mar.

[ocr errors]

min. mean "Frequency of the pulse before the observations

66 60 62.36 Morning :

Evening: min.

min. mean Average frequency of the several series of observations S 64.5 57.33 61.28 63 56 58.71

56 any } 62

59.18 62 54 56.54 series of observations Differ, between the original

6 0

3.23 8 4 5.82 frequency and least number

In the second set of observations, viz: those to show the effect of food, precisely the same plan was adopted as in the above, and the fourteen series of observations give the following mean results:

[blocks in formation]

.

[ocr errors]

Frequency after meal

81 70 75 74 60 69.15 Increase

21 10 12.92 12 0 7.15 Duration of effect in hours, 3.75 1

2.02 1.75 0

.09 Diminution per hour

12
4

6.4 40 6 7.8 *Exceptions to the rule of 2

29.21 per cent.

13.33 per cent. progressive diminution }

The following are the average results of six experiments, in which the pulse before the meal was sixty.

Morning :

Evening: min.

min.

maz.

mean

mar.

mean

.

3.75

Frequency after the meal, 81 70 75 72 60 63
Increase

21 10 15

12 0 8 Duration of effect in hours,

2

2.75 1.75 0 87 Diminution per hour

6.9

5.45 20 6.8 9.02 Exceptions to the rule of 2

26.47 per cent.

11.76 per cent. progressive diminutions

After noticing the uniformity of the results, the author remarks that, “ by far the most remarkable fact established by these observations, is, that the same food which in the morning increases the frequency of the pulse from five to twelve beats, and keeps it raised above its natural number from one to two hours, may in the evening produce no effect whatever." He

*That is to say, the instances in which the pulse, instead of being less frequent, was more frequent than in the preceding observation, were in the morning in the proportion of 29 per cent., and in the evening of 13 per cent.

refers to his table of details, which our space does not permit us to insert.

Having given the results of his observations much more minutely and in extenso than we have noticed, he proposes the following as facts established by them:

66

61. The pulse of a healthy adult male in a state of rest, unexcited either by food or exercise, is most frequent in the morning, and gradually diminishes as the the day advances.

2. The pulse diminishes in frequency more rapidly in the evening than in the morning.

3. The diminution of the frequency of the pulse is more regular and progressive in the evening than in the morning.

4. The effect of food is greater and more lasting in the morning than in the evening; and, in some instances, the same food which in the morning produces an effect considerable both in amount and in duration, has no effect whatever in the evening."

The theory which Dr. Guy proposes upon the subject, and in support of which he brings forward some additional facts and arguments, is that:

Early in the morning, after we have been completely refreshed by sleep, the strength of the body is at its maximum; all its functions are performed with vigour; and all the causes of excitement produce their greatest effect. But activity of body or of mind, and the application of stimuli of different kinds, produce debility, which goes on increasing as the day advances. So long as the body continues in perfect health, this increasing debility produces a sedative effect on the action of the heart; the frequency of the pulse is diminished; and it becomes less and less affected by the application of stimuli. Sleep restores strength and vigour to the body, and again confers upon it that excitability of which fatigue had deprived it. But fatigue, or the want of rest, may give rise to a state of debility which is incompatible with health; and which is accompanied by increased frequency of pulse, and increased susceptibility of the action of stimuli

. It is, of course, quite impossible to draw the line between that debility which is consistent with health, and that which in itself may be regarded as a departure from it, between that degree of exhaustion which is attended by torpor of the functions, and that which is accompanied by increased excitability: but it may be stated, as a general rule, that debility without disease is productive of an infrequent pulse.”

Lastly, he suggests as a practical application, that in cases where we wish to afford nourishment with as little excitement as possible, we should give the food in the evening. And that where it is desirable to produce as great an effect as possible, by the exhibition of remedies, we should choose the morning.

4.-Observations on Poisoning, by the Vapours of Burning Charcoal and Coals. By Golding Bird, M. D., fc.

.

Passing over several pages of this paper of Dr. Bird's in which he institutes the question of-what is the poisonous ingredient in the vapours of burning charcoal, &c.—and in reference to which, from the facts and experiments adduced by him, he concludes that it is carbonic acid in a large majority of cases, but that in some few, some other unknown substance is probably the noxious agent -we shall at once enter upon a notice of his "physiological and pathological effects resulting from the inhalation of charcoal vapour."

The “symptoms” produced by carbonic acid are well marked, but not entirely characteristic, as they simulate very nearly the premonitory symptoms of apoplexy. Under this head however, it is not desirable to condense the page in which the author portrays them, and we shall quote him at some length:

“The person exposed experiences an intense, penetrating, and throbbing headache, accompanied by a sense of weight and heat, especially about the occipital region; strong pulsation in and a sense of tightness across the temples ; vertigo ; increased action of the heart, often accompanied by violent

a

palpitations; confusion of ideas, and partial failure of memo ry, accompanied, in many instances, by a disposition to nausea and hysteric sobbing. If the individual who has been thus exposed be now removed from the vitiated atmosphere, and placed in a current of cool air, especially in the recumbent position, with the application of hot water bottles to his feet, if they be (as under these circumstances they usually become) cold, these symptoms gradually vanish, and in a few hours the patient recovers. But if the person be not so fortunate, and remain exposed to the poisoned atmosphere, a buzzing noise in the ears succeeds, followed or accompanied by partial or total loss of vision; and an undefined, vague, feeling of intense horror or dread, which is rapidly succeeded by an irresistible disposition to somnolency or syncope.

Subsequently, and in a space of time varying probably with the state of vitiation of the atmostphere or temperament of the individual, all power of volition disappears, the pulse and palpitation of the heart, which were previously above 100 or 200, diminish in frequency, falling to 40 or 50; respiration becomes slow and laborious; the surface universally cold, and often livid ; the lips becoming blue or violet; the eyes retaining, in most cases, their lustre: gradually, these symptoms increase in intensity, with frequently the accession of tetanic convulsions, and in a few instances raging delirium, white or bloody foam appears before the mouth and nostrils, vomiting supervenes, and the sufferer expires in the act; occasionally, however, breathing his last without its occurrence; in which case, the tongue is found protruded, or clenched firmly between the teeth ;—the countenance always retaining an expression of deep and placid calm, the victim being generally found lying on the fatal apartment in a calm and sleeplike attitude, which even the vomiting, that often occurs in the last moments of existence, had been as ineffectual in disturbing, as it had been impotent in arousing the sufferer to a sense of his perilous situation. These symptoms are, with a single exception, recognized by all toxicological writers as constant. The exception to which I allude, is, vomiting-a certainly not very unfrequent accompaniment of death by charcoal fumes, although I am aware it has been lately denied as almost impossible to occur. It is for us, however, to regard facts that have occurred, and therefore likely to happen again; rather than assertions of what ought, on theoretical grounds, to take place.”

Having detailed the symptoms, the author devotes some space to an enumeration of the appearances presented by

« ZurückWeiter »