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Sir William Osler and the nature of essential hypertension

Journal of Human Hypertension volume 28, pages 15–17 (2014)Cite this article

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On 2 November 1912, William Osler, Regius Professor of Medicine at the University of Oxford, published a paper in the British Medical Journal entitled An Address on High Blood Pressure: its Associations, Advantages and Disadvantages.1 It was a review based on a lecture he had given to the Glasgow Southern Medical Society the previous October at the Royal College of Physicians and Surgeons of Glasgow. Osler provided a classification of hypertension that remains relevant to this day; he did this on the basis of his extensive clinical practice at a time when there were no cross-sectional or long-term epidemiological studies that we now take for granted. In a sense, hypertension was a new disease. Whilst the ancient physicians, Huang Ti in China, Hippocrates in Greece and Avicenna in Persia had all noted that a full volume pulse was a hazard to health, this did not permeate into clinical practice. There was no objective way that blood pressure could be measured. The Rev Stephen Hales had measured the intra-arterial pressure in a horse in 1733, but this was clearly not applicable to patient care.2 In the nineteenth century, a great many attempts had been made to measure blood pressure, but it was not until the development of the sphygmograph, notably by Étienne-Jules Marey (1830–1904) in Paris and Frederick Mahomed (1849–1884) in London, that the measurement of blood pressure in patients became possible.2, 3 However, the sphygmograph, which measured the amplified radial pulse was not reliable and was difficult to use.

It is not surprising, therefore, that in the first edition (1892) of his classic textbook, The Principles and Practice of Medicine, Osler did not mention blood pressure, hypertension or its more archaic name, hyperpiesis.4 So what had changed by 1912? The answer is that by the early twentieth century, a viable method of measuring blood pressure in clinical practice had become available. The breakthrough came in 1896 with Scipione Riva-Rocci’s paper, published in the Gazetta Medica di Torino entitled Un Nuovo Sfigmomanometro.5 With the use of an occlusive upper arm cuff, systolic blood pressure could now be measured easily by palpation of the radial pulse. One year later, Hill and Barnard6 described a very similar apparatus, although this relied on an aneroid gauge rather than a mercury manometer.

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References

  1. Osler W . An address on high blood pressure: its associations, advantages and disadvantages. Br Med J 1912; 2: 1173–1177.

    Article  CAS  Google Scholar 

  2. O’Brien E, Fitzgerald D . The history of blood pressure measurement. J Human Hypertens 1994; 8: 73–84.

    Google Scholar 

  3. Lewis O . Frederick Henry Horatio Akbar Mahomed: ‘a brave and ambitious explorer’. J Human Hypertens 1997; 11: 255–261.

    Article  CAS  Google Scholar 

  4. Osler W . The Principles and Practice of Medicine. D Appleton and Company: New York, 1892.

    Google Scholar 

  5. Riva-Rocci S . Un nuovo sfigmomanometro. Gazz Medi Torino 1896; 50: 981–996.

    Google Scholar 

  6. Hill L, Barnard H . A simple and accurate form of sphygmomanometer or arterial pressure gauge contrived for clinical use. Br Med J 1897; 2: 904.

    Article  CAS  Google Scholar 

  7. Fulton J F . Harvey Cushing; a Biography. Charles C Thomas: Springfield, Illinois, USA, 1946.

    Google Scholar 

  8. Korotkov NS . To the question of methods of determining the blood pressure. Rep Imp Military Acad 1905; 11: 365–367.

    Google Scholar 

  9. Mahomed FA . The etiology of Bright’s disease and the prealbuminuric stage. Med Chir Trans 1874; 57: 197–228.

    Article  CAS  Google Scholar 

  10. Pickering GW . High Blood Pressure. J & A Churchill: London, 1955.

    Google Scholar 

  11. Frank E . Bestehen Beziehungen zwischen chromaffinem System und der chronischen Hypertonie des Menschen? Ein kritischer Beitrag zu der Lehre von der physio-pathologischen Bedeutung des Adrenalins. Deut Arch Klin Med 1911; 103: 397–405.

    Google Scholar 

  12. Pickering GW . The Nature of Essential Hypertension. J & A Churchill: London, 1961.

    Google Scholar 

  13. Cushing H . The Life of Sir William Osler, Vol. 1 and 2. at the Clarendon Press: Oxford,, 1925.

    Google Scholar 

  14. Osler W . Science and Immortality. Constable & Company: London, 1904.

    Google Scholar 

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  1. Department of Cardiovascular Sciences, City Hospital, Birmingham, UK

    D G Beevers

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  1. D G Beevers
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Correspondence to D G Beevers.

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Beevers, D. Sir William Osler and the nature of essential hypertension. J Hum Hypertens 28, 15–17 (2014). https://doi.org/10.1038/jhh.2013.40

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