About a hundred years ago Dr. Johann Ludwig Formey,1 in a book on the pulse that has long since been forgotten, wrote:
The evaluation of the significance of the pulse in disease is made very difficult by the fact that there is no normal pulse and that therefore it is impossible to know when deviations from the normal are pathologic. Every individual, every age, every constitution, each sex, is in itself of determining influence on the character of the pulse. These factors are further modified by the climate, the seasons, the mode of life, and emotional make-up of the individual.
Volkmann2 put the case more strongly:
Counting the pulse of persons whose previous rate is unknown is worthless for the diagnosis and treatment of disease, and the use of the second watch at the sickbed approaches charlatanism unless one takes pains to inquire into the many circumstances on
BOAS EP, WEISS MM. THE HEART RATE DURING SLEEP AS DETERMINED BY THE CARDIOTACHOMETER: ITS CLINICAL SIGNIFICANCE. JAMA. 1929;92(26):2162–2168. doi:10.1001/jama.1929.02700520014006
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: