BP History
People first began looking at blood pressure a couple of hundred years ago. In fact, the first recorded time that someone measured blood pressure was in 1733 by a guy named Stephen Hales. He was an English animal doctor that spent a lot of time measuring the blood pressures of a lot of animals in his clinic. However, at that time his technique was invasive. He actually opened up an artery and inserted a tube into it to watch the blood rise and fall. You couldn’t do this on the general population. I don’t care what year it was!In 1847 someone finally found a way to measure human blood pressure and was able to record it. It was still invasive though. How they did it was to, again, insert a tube into a human artery and hook up a float to the tube. Then, they attached a quill pen to that. The quill pen then was arranged to write on paper attached to a rotating drum. Sounds highly advanced. They called it “Ludwig’s Kymograph” or “wave writer” in Greek. I can’t imagine that this was a voluntary thing.
In 1855 another physician named Vierordt, found that with enough pressure, the arterial pulse would disappear. This particular guy used an inflatable cuff around the arm to put pressure on the artery. This is starting to sound familiar.
Check this out. In 1860, Etienne Jules Mary, a French physician/cinematographer, piggybacked on the idea of the inflatable cuff. He called it a sphygmograph. It could accurately measure the pulse rate, but couldn’t consistently measure the blood pressure. It was this design that first could be used in the doctor’s office with a small degree of success.
Progress continues its march. In 1881, Samuel Siegfried Karl Ritter von Basch (do people still name their kids like that?!) invented, what he called, the sphygmomanometer. This was the first invention to accurately measure blood pressure in any animal without having to open them up first.
After this, an Italian physician named Scipione Riva-Rocci continued working with this idea and finally developed the mercury sphygmomanometer in 1896. It still used the inflatable cuff over the upper arm and was connected to a tube with mercury in it. This measured the amount of pressure put on the arm that cut off the arterial pulse. But then, Riva-Rocci’s sphygmomanometer was spotted by an American neurosurgeon named Harvey Cushing while he was travelling through Italy. Just like any good American, he saw the potential benefit and he returned to the US with the design in 1901. He modified the design for better use in his office and, voila, the sphygmomanometer became commonplace.
But, at this time, the sphygmomanometer could only be used to determine the systolic blood pressure. No one understood the benefits of the diastolic blood pressure or how to measure it. Then comes along Nikolai Korotkoff. Apparently, he was the first to really listen to the sounds made by pressure on the arteries in 1905. This guy found that there were characteristic sounds at certain points in the inflation and deflation of the cuff. They named these “Korotkoff sounds”! It was figured out that these sounds were made by the abnormal flow of blood through the artery. It was also found out that these sounds corresponded to the systolic and diastolic blood pressures.
From that point on people have been studying the pressure of the blood in the arteries and how it relates to different health conditions. Now, the measurement of the blood pressure is part of the “vitals” measurements that every nurse takes on every patient that they care for in the hospital or in the doctor’s office. We have found that it is a direct indicator of how a patient may be doing. Good or bad.
