THE NATURE OF THE SO-CALLED "CAPILLARY PULSE"

ERNST P. BOAS
1922 Archives of Internal Medicine  
The "capillary pulse" has been of interest to clinicians ever since Quincke 1 first called attention to it in 1868. Nothing, however, has been added to his original description of the condition, nor to his discussion of the probable mechanism by which it is brought about. Two observers before Quincke noted the phenomenon in isolated cases, but failed to appreciate the frequency of its occurrence or its significance. Lebert2 cites the case of a patient with an aortic aneurysm who exhibited
more » ... who exhibited systolic flushing and diastolic paling of the cheeks. Ascher-son3 observed a child 7 years of age with varicella following scarlatina, in whom the papules and the bases of the vesicles reddened in diastole and paled in systole. This was very evident for four days, but after that it was only demonstrable when the skin about the lesion was stretched. Both authors attributed the phenomenon to a pulsation of the capillaries. It was Quincke, however, who observed the flushing and paling of the tissues under the finger nail not only in aortic insufficiency, but in a variety of other conditions. In patients with incompetent aortic valves it is most manifest, but it can be observed in many normal individuals. Quincke calls to mind that ordinarily, because of the elasticity of the arteries, the blood flows through the capillaries in a continuous stream ; but that with venous obstruction, or with a marked lowering of the blood pressure associated with a slow pulse rate, the capillary flow may become pulsatile. A marked relaxation of the arterial wall may have the same effect. Thus Claude Bernard explained the pulsation of the capillaries and veins of the submaxillary gland which he observed on stimulation of the chorda tympani. In a later paper Quincke 4 emphasizes that a great difference between the systolic and diastolic pressures is essential for the visualization of the capillary pulse. He observed the phenomenon in anemic individuals, and in those with low blood pressure, an overactive heart, and a pulse From the Medical Division of the Montefiore Hospital for Chronic Diseases.
doi:10.1001/archinte.1922.00110060057004 fatcat:bvaw25xydbgkzcqf6pbwavxbci