Recently, several workers pointed out that the finger-tip plethysmography is a useful method, representing cardiac hemodynamic abnormalities in patients with heart failure including latent heart insufficiency. It seems to be reasonable that the peripheral vasoconstriction which appear in cardiogenic shock may bring about a rigid or low amplitude pulse on patient’s plethysmogram, so it will also be reasonable that such pulse should be recognized in patients with forward failure. It was observed that such low amplitude pulse with latent heart failure normalized after administration of a small amount of digitalis, which had an association of conspicuous improvement of clinical signs.

It must be emphasized, however that the continuous long hours recording of finger plethysmogram usually showed a rhythmical or periodic alternating of it’s amplitude and wave forms as shown on finger A (paper speed for the recording is 1 mm/sec. Fig. 1

In this Figure 1, pattern A, B and X may appear rhyth-mically with good reproducibility, but B and C are sporadic and specific in this individual, and A is suitable for the

analysis of it’s waveform (Fig. 2). B or X has no clinical significance since it will appear almost always on every person with or without cardiovascular disease. According to the facts mentioned, above it might be considered that the long hours recording of finger plethysmogram is necessary as a rule for the analysis of the volume of the pulse Fig.2:

Dr. Muhammad Ilyas, who is a well-known sphygmologist, has written this monograph, and in this book expressions contain high level of discussion and explanations are clear-cut. I think it is a very useful and valuable publication for the clinical practice. I would like to congratulate him for his success.

Prof. M. Yoshimura

Dokkyo University School of Medicine

Mibu, Tochigi 321-02

Japan