The Physiological Factor in Diagnosis; a Work for Young Practitioners

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— This may be due to nervousness ; and it is an excellent rule to take the pulse when the patient enters the room, or you enter the patient's room; and if found fast, to wait till towards the end of the interview, and take it again.
If then found much slower, it is clear the rapidity found in the first counting of it was simply nervousness. Then the pulse rate is heightened in fevers and in inflammations ; and this fact win often tell whether severe pain is inflammatory (when the pulse is quick
...), or neuralgic (when the pulse-rate is normal). Or the pulse may be rendered rapid by alcohol recently taken, or by long-past indulgence. The pulse is very rapid in conditions of dilatation of the left ventricle, when a little blood only is pumped at each systole from the overfull ventricle. The pulse, too, mounts up in rate when the right ventricle is being over-distended, and the patient is sinking from thoracic disease. In pulmonary aflections rapidity of the pulse-rate is of bad omen. ' In chronic in- flammations the frequency of the pulse is a guide in judging of the degree of constitutional disturbance, or the tolerance of them by the system.

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