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July 1914


Author Affiliations


From the East Medical Service of the Massachusetts General Hospital.

Arch Intern Med (Chic). 1914;XIV(1):48-55. doi:10.1001/archinte.1914.00070130055004

For decades clinicians have believed that many of the grave symptoms and a large number of the deaths in pneumonia were directly due to failure of the circulation. In 1889 Romberg1 and his associates studied the problem and reached the conclusion that, while fatal circulatory failure did occur in rabbits inoculated with lethal doses of pneumococci, the failure was not of myocardial origin as had been supposed, but was invariably caused by the exhaustion of the vasomotor center in the bulb.

Since that time physicians have tried to combat the failure of the vasomotor mechanism in pneumonia by administering drugs which would augment the activity of the vasomotor center.

The results have been sufficiently confusing to make a re-investigation desirable. The present communication deals only with the blood-pressure in pneumonia. Other phases of the subject will appear in later papers.

If it be true that

Romberg, Pässler, Bruhns and Müller:  Experimentelle Untersuchungen über die allgemeine Pathologie der Kreislaufstörung bei acuten Infectionskrankheiten ,  Arch. f. klin. Med. , 1899, lxiv, 652.
Weigert, K.:  Ueber das Verhalten des Arteriellen Blutdrucks bei den acuten Infectionskrankheiten ,  Samml. klin. Vortr. (Volkmann's) Inn. Med. , No. (138) , p. 459.
Gibson, G. A.:  Some Lessons from the Study of the Arterial Pressure ,  Edinburgh Med. Jour. , 1908, n. s., xxiii, 17.
That point at which the fourth tone phase passed into the fifth was called the diastolic pressure.
Gordon, G. A.:  Some Remarks on the Value of Accurate Blood-Pressure Estimation ,  Edinburgh Med. Jour. , n. s., iv, 31.