THE PHYSIOLOGICAL RESPONSE OF THE CIRCULATORY SYSTEM TO EXPERIMENTAL ALTERATIONS : II. THE EFFECT OF VARIATIONS IN TOTAL BLOOD VOLUME.
The pericardium presents a limiting or constricting action to acute dilatation of the heart. The diastolic pressure tends to approach the systolic pressure in a circulatory system distended with blood. The limiting action of the pericardium may be responsible for the small differences in the size of the heart noted by Meek and Eyster in their studies on the effect of plethora. The views concerning the function of the pericardium are divergent. That it may restrict the heart in cases of acute dilatation is shown in the above experiments. If the tension upon the pericardium be exerted over a prolonged period of time, as occurs in cases of pericardial effusion, the pericardium readily enlarges. If, however, the intrapericardial pressure should at any time equal the pressure in the venae cavae, blood would no longer enter the heart and the condition would become fatal. In recovery experiments, pericardiectomy was followed by no demonstrable effect upon the general health of the dog, upon the response to exercise, or upon the size of the heart (6).
Laboratory of Surgical Research, Lakeside Hospital and Western Reserve University, Cleveland.
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Beck
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Holman