_Of the Pulse._
When we consider the admirably curious structure of the human mechanism,
it must clearly appear, how easily the animal œconomy may become
disordered. But so kind has the ALLWISE AUTHOR of our existence been to
his creatures, that on the slightest indisposition, the whole system is
sensible of the least disagreeable sensation; and every part, with a
social and sympathetic friendship, is ready to relieve the fabric from
whatever is obnoxious, and causes the disturbance.
As nothing has a greater share in life than the blood, so nothing
likewise on the least indisposition, is sooner set in commotion, and
gives the alarm, than this very liquor, in which life itself is
contained; and the circulation of this fluid in the arteries, furnishes
us with the greatest prognostic, namely, the _pulse_, by which we may,
with any degree of certainty, judge of the state of the body, and
foretell good or bad events. How beneficial it is then to be acquainted
with this knowledge, I shall leave to every rational being to determine.
Every artery in the living body constitutes a _pulse_, as has been
explained in Sect. V. in the foregoing lecture.
And it is demonstrative from simple reason, that the pulsation of such
arteries must be in proportion to their magnitude, greatest in the
heart, whence they take their origin; till the vibration must gradually
be lost to the touch, as they become insensibly small, and lose
themselves in their ramificatory capillary tubes.
The artery which is most convenient to our examination, is that which
lays immediately to the touch on our wrist, below the thumb, on the
radius, just below the knuckle of that bone; and it is there we are best
able to distinguish the pulsation of the arteries, as being most exposed
to the external touch; because it is immediately between the skin and
the flat of that bone.
Thus much premised, we will first consider the _pulse_ in the sound
state; and next make a comparison with that in people labouring under
diseases.
In a full grown man, in the vigour of health, the pulse ordinarily beats
once to every second, that is, 60 times in a minute, 3600 in an hour,
and 31,536,000 times in a year. It varies however in different subjects,
according to the stature, temperament, condition, time, and action of
the same; insomuch, that two persons equally in a good state of health,
shall, however, differ widely in their pulses. Yet, notwithstanding,
there are peculiar signs, which will ever make a true distinction
between health and sickness; practice however is requisite to form a
proper judgment of such distinction.
In order to lay a proper foundation to understand the nature of this
great prognostic, I shall divide the pulse into the following classes:
1st. _A full_, _slow_, and _regular_ pulse, denotes a perfect state of
health; for whilst the blood moves regularly in the arteries, without
pain to the nervous system, or disturbance to the animal œconomy, the
pulse will beat precisely regular, without trembling, fluttering, hurry,
distinction, or feebleness, and discover to the touch, a peculiar
easiness; and this, every one, who wishes to become master of that
subject, should carefully attend to.
2dly. _A full_ and _quick pulse_, indicates a fever; for by the
irritation of the nerves, the vibration of the arteries are accelerated.
If a gentle perspiration attends it, it may be deemed salutary; and with
this pulse it appears, that nature makes a vigorous effort to expel what
is obnoxious: therefore in such a pulse, a gentle perspiration generally
gives relief.
3dly. _A full_, _quick_, and _hard pulse_, denotes great irritability in
the nerves, and a redundancy of blood; this is the pulse of a fever; and
here bleeding, if timely applied, is very requisite, as also medicines
which promote perspiration.
4thly. _A small_ and _quick pulse_, denotes an irritability in the
nervous system, and a contraction of the arteries; this is generally the
pulse which attends sudden shocks and frights, as also in the cold fits
of agues. The causes should carefully be attended to: if, from a sudden
shock, bleeding is useful; but in the latter case, it is hurtful. It
seldom lasts long, and a full feverish pulse generally follows, and the
state of the patient ought here to be the guide: for, the same pulse may
proceed from too great a plenty of blood, as well as from a deficiency;
consequently requires different treatment; and this shall be pointed out
more fully hereafter.
5thly. _An irregular full pulse_, is at all times a bad one; many may be
the causes, and generally denotes a great confusion in the nervous
system, and in the circulation of the blood. This pulse is generally the
attendant on violent inflammations, phrenzy, delirium, &c. and if it
continues any time, forebodes great danger: bleeding in time is greatly
requisite, and other remedies, in order to assist the nerves, and bring
the circulation to its proper regulation again.
6thly. _An irregular small pulse_, is frequently the attendant of an
emaciated constitution, putrid fevers, and consumptions; and this
dangerous pulse too generally forebodes the approach of death. The more
irregular the pulse grows, _small_, _weak_, _trembling_, and leaves off
by irregular intervals, the sooner dissolution is at hand; till at last,
the pulse entirely disappears, and life ceases. But dangerous as this
pulse is, yet it must be observed, that it often appears in the
strongest constitutions, as in sudden emotions of the mind, falls, &c.
or in a swooning. This is also the last and the first pulse in
suffocations; or in other words, the struggling pulse between life and
death.
These few distinctions of the pulse we will let suffice, as they, when
properly attended to, will in all cases enable us to make a true
distinction between health and the different stages of sickness, and
accordingly direct us to a true method of cure.
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