Concerning the problem of the methods of blood pressure measurement

On the basis of his observations, the author came to a conclusion that a compressed artery in normal conditions does not produce any sounds. Using this circumstance, the author proposes an auscultatory method to measure blood pressure in humans. The Riva-Rocci cuff should be posed in the middle third of the arm; the pressure in the cuff is rapidly increased up to complete obstruction of the distal blood circulation. Thereafter, letting the pressure in the cuff decrease, the artery just below the compression should be auscultated with a child stethoscope. At the beginning of the procedure, no sound can be heard. After the mercury column drops to a certain point, first a short sound appears, which indicates the passing of the blood under the cuff. Consequently, the level of the pressure when the sounds appear can be taken as the maximal blood pressure. A further decrease in cuff pressure is accompanied by compression murmurs on the artery, which later are again transformed into definite sounds (second ones). Finally, all sounds disappear. This indicates the free movement of the pulse wave; in other words, at this point, the minimal blood pressure becomes higher than the cuff pressure. Thus, the mercury readings at this moment can be taken as the minimal blood pressure. The animal experiments gave confirmative results. The first sound appears earlier than the distal pulse (10–12 mmHg), for the palpation of the latter on the arteria radialis a stronger pulse wave is required.

[Translated and reproduced from: Korotkov NS. Concerning the methods of blood pressure measurement (from the clinic of S. P. Fedorov). Proceedings of the Emperor's Military Medical Academy St Petersburg 1905; 11:365–367; for a fascimile of the original publication, see Fig. 1]

Fig. 1: Facsimile of original publication.