THE INFLUENCE OF THE SOFT TISSUES OF THE ARM ON CLINICAL BLOOD-PRESSURE DETERMINATIONS

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Abstract
A widespread impression exists that the degree of development of the musculature of the arm, or the size of the member, exercises considerable influence on blood-pressure readings made by the usual clinical methods, employing circular compression of the arm for the obliteration of the pulse. Von Recklinghausen's work demonstrated clearly that, with a sufficiently wide arm-piece, at least 12 cm., the latter factor could be entirely eliminated. Subsequently Müller and Blauel1 made a critical study of this question, by comparison of clinical determinations with direct manometric measurements made in three patients during operation requiring the amputation of a hand. Their results showed an average reading with the broad cuff 9 to 10 mm. above the true systolic arterial pressure. They, of course, found very large errors with the narrow arm-piece and with Gärtner's method. Among their conclusions they state that, while the largest errors stand in

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