A Brief Journey into the History of the Arterial Pulse

Abstract

Objective. This paper illustrates the evolution of our knowledge of the arterial pulse from ancient times to the present. Several techniques for arterial pulse evaluation throughout history are discussed. Methods. Using databases including Worldcat, Pubmed, and Emory University Libraries' Catalogue, the significance of the arterial pulse is discussed in three historical eras of medicine: ancient, medieval, and modern. Summary. Techniques used over time to analyze arterial pulse and its characteristics have advanced from simple evaluation by touch to complex methodologies such as ultrasonography and plethysmography. Today's understanding of the various characteristics of the arterial pulse relies on our ancestors' observations and experiments. The pursuit of science continues to lead to major advancements in our knowledge of the arterial pulse and its application in diagnosis of atherosclerotic disease.

Discourse on pulse in medieval Persia—the Hidayat of Al-Akhawayni (?–983AD)

“…A clear description of rhythm and better prognostic value of the regular-irregular rhythm compared with the irregular-irregular rhythm has been mentioned in the Hidayat. This classification is similar to what is currently known of the arterial pulse characteristics in arrhythmias such as atrial fibrillation [15]. The subject of regularity/irregularity of the pulse dates back to the pulse-lore of the ancient Hindu physicians [19].…”

“…Every physician should measure and compare these time components [in different pulse cycles] with each other; movement time with movement time, and pause time with pause time… and this character is called the meter [of the pulse]… a child's pulse is different from a young adult's pulse, and the young adult's pulse is different from a middle-age or elderly person's pulse… when the pulse of a child resembles the pulse of an adult or when the pulse of an adult resembles the pulse of a child, it is named an Undesired Pulse. A pulse that is not compatible with those pulses mentioned earlier; the child's, the young adult's, the middle-aged or elderly person's pulse, is named an Inconsistent-with-Meter Pulse (Arrhythmic Pulse)… …and the tenth character [of the pulse] is a person who examines a patient's artery recognizes the serious diseases… when the artery under the [examiner's] hand is warmer than other parts [of the body], it means that the disease is serious… It was known to the medieval physicians that pulse cycles were reflections of cardiac cycles [15]. This relationship has been probably adopted from the ancient Egyptian medicine [16][17][18], as later Herophilus (335-280 BC), Rufus of Ephesus (1st-2nd century AD) and Galen (129-200 AD) noted that the heart was the cause of arterial pulse [19].…”

Screening for Atrial Fibrillation Using Smartphones and Smartwatches

“…The arterial pulse has been palpated since ancient times to evaluate disease states. 16 PPG has modernised the analysis of this physiological signal. In the era of multifunctional smartphones and smartwatches, it is very likely that PPG will be increasingly used to empower the general public to manage their own healthcare.…”

The role of simulation in neurosurgery

“…In 275 BC, Herophilus of Chalcedon (335-280 BC), founder of the first school of anatomy in Alexandria, encouraged human cadaveric studies, leading to significant advancements in the medical knowledge [8,9] (Fig. 3).…”