Observations on some cases of permanently slow pulse

Stokes W(1846) Observations on some cases of permanently slow pulse. Dublin Quarterly Journal of Medical Science 2:1 73–85.

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Abstract: 1. In the cases of anemia studied (pernicious anemia, chlorosis, and secondary anemia) the blood flow in the hand is smaller than the normal flow. 2. Accepting Plesch's result, that the minute volume of the heart is increased in the anemias, the diminution in the hand flow is interpreted as a sign of a vasoconstriction in peripheral parts, which facilitates the increased flow through the lungs. 3. The deficiency in the hand flow is less in the chlorotic group than in the other cases of anemia. The explanation suggested is that the increased total volume of the blood in chlorosis permits the normal amount of hemoglobin to circulate through the lungs without a marked increase in the peripheral vasoconstriction. 4. The view that the diminution in the cutaneous blood flow in anemia is a necessary compensatory arrangement for increasing the flow through the lungs affords a natural explanation of the beneficial effect in many cutaneous disorders of general measures, especially those aimed at improving the quality of the blood. 5. In a case of bradycardia with a pulse rate permanently below 40 during rest in a sitting position, the hand flow was normal.

Context

• Written by one of the physicians for whom Stokes-Adams attacks (cardiogenic syncope, possibly convulsive) are named. See also Adams.