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October 7, 1939


JAMA. 1939;113(15):1431. doi:10.1001/jama.1939.02800400059024

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To the Editor:—  The special article on this subject in The Journal July 22 induces me to emphasize paragraph 5. Equal and not excessive pressure should be made by the bell of the stethoscope in taking the blood pressure. Particularly in children, and occasionally in adults in whom the blood pressure is low, especially when the diastolic blood pressure is low, it is necessary to place the bell of the stethoscope in such a manner that the entire ring of pressure is equal and that the upper ring of the bell does not press harder than the lower. If the upper half of the ring of the pressing bell of the stethoscope should be pressed harder, the pulse beat will continue to be heard long after the true diastolic point has been reached. The extra pressure of the bell of the stethoscope acts in the same manner as if there

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