The Smart Magazine About Medical Technology Innovations

#12 - Imaging's New Horizons

Dead Horses, Rubber and the Sphygmograph

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Even if measuring blood pressure is one of the most common examinations, most physicians do not know how medicine achieved the capability to determine exactly what is happening inside our veins. Like most other modern medical technologies, devices for blood pressure measurement depend on the research of doctors from numerous countries that lived centuries ago.

The knowledge about the fact that blood circulates in our body, recorded in 1628 by English physician William Harvey, can be considered as a basis for the following findings on blood pressure measurement. Almost 100 years later, in 1713, Stephen Hales conducted the first – rather bloody and deathly – blood pressure measurement: He inserted a long glass tube into a strapped horse’s artery to observe the rising level of blood inside the tube. He published about this invasive catheterisation method in 1733.

ME12_korotkoff

The Russian doctor Nikolai Korotkoff

Finally, in the 19th century, with the auscultatory and oscillometric method, techniques were introduced to determine blood pressure more sustainably: German physiologist Karl von Vierordt, Austrian Pathologist Karl Ritter von Basch and French physician and inventor Etienne-Jules Marey developed different types of the sphygmograph (meaning “pulse writer”). This apparatus, attached to the patient’s wrist, could document the pulse graphically and determine the blood pressure as graphic amplitudes.

Introducing the Rubber Cuff

“However, the determination of the absolute blood pressure was not yet feasible”, explains Dr. Siegfried Eckert, head of angiology department at the Clinic for Cardiology in Bad Oeynhausen, Germany. He told Medical Expo in an interview that “the next milestone for the development of blood pressure measurement was the introduction of rubber in Europe.”

The Italian internist Scipione Riva-Rocci invented a cuff around the upper arm made of this rubber material in 1896. By inflating it, he interrupted the blood stream so that the pressure – palpable at the pulse – disappeared. When deflating the cuff, he determined the blood pressure in the moment when blood started flowing and becoming palpable again. But it was only the systolic blood pressure. The diastolic value was still not measurable.

“Due to Russian doctor Nikolai Korotkoff we can today also determine diastolic blood pressure”, says Dr. Eckert. In 1905 Korotkoff combined the compression of the brachial artery according to Riva-Rocci with listening to the swirling sounds of the blood with a stethoscope (auscultative method). His famous ‘Korotkoff sounds’ blazed, together with the findings of his ancient colleagues, the trail to modern blood pressure measurement.


About the Author

Kristina Müller is a freelance journalist writing mainly about nautical and medical issues.

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