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It has been mentioned in the introduction to the last paper1 that when proper precautions are taken there is a very fair degree of constancy in the results obtained in successive observations on different days on one and the same patient, provided gross changes in his clinical condition are excluded. Accordingly, a marked change in the flow not accounted for by changes in the external conditions, especially in the external temperature, always suggests some decided alteration in the clinical state of the patient. On the other hand, in certain cases, information may be obtained as to the state of the patient; for example, in regard to the lability of his vasomotor mechanism or the power of adaptation of his heart, by purposely changing the external conditions or by taking advantage of changes that have spontaneously occurred, in order to determine their effect
STEWART GN. STUDIES ON THE CIRCULATIONN IN MAN: X. THE BLOOD-FLOW IN THE HANDS IN DISEASES OF THE HEART. Arch Intern Med (Chic). 1914;XIII(1):1–38. doi:10.1001/archinte.1914.00070070006001
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