CLINICAL STUDIES ON INCOORDINATION OF THE CIRCULATION, AS DETERMINED BY THE RESPONSE TO ARISING 1

Abstract

The response of the circulation when the subject arose, as detd. by the ballistocardiograph, has been employed as a test of its coordination, i.e., of the ability to adapt the cardiac ouput to the needs of the moment. Normal standards for circulatory coordination have been detd. by a statistical analysis of the results of 120 tests made on 75 healthy young adults, before and after arising. Over 150 patients have been studied also. In healthy persons, the physiological adjustment necessitated by assuming the erect position is largely accomplished by the vasomotor mechanism and the cardiac output changes but little. In many sick persons, the cardiac output changes much more and the abnormality may be in either direction. In the commoner type, the circulation is unduly increased on arising; this type is found with great frequency in many types of disease. Many weakened patients cannot stand without in-voluntary muscular movements of the lower extremities. Such movements are always called forth in persons subject to fainting before they collapse, and they seemed designed to support the circulation. Patients with symptoms referable to their circulation without detected organic disease, the group often diagnosed neurocirculatory asthenia, show in-coordination of the circulation in a large majority of cases.