page_title: Frederick Akbar Mahomed
section_title: Education and Career
hierarchical_section_title: Frederick Akbar Mahomed / Education and Career
caption_attribution_description: English: Identifier: handbookofphysio00bake (find matches) Title: Hand-book of physiology Year: 1892 (1890s) Authors: Baker, W. Morrant, (William Morrant), 1839-1896 Harris, Vincent Dormer Kirkes, William Senhouse, 1823-1864. Hand-book of physiology. 13th ed Subjects: Physiology Human physiology Publisher: London&#160;: John Murray Contributing Library: Francis A. Countway Library of Medicine Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School View Book Page: Book Viewer About This Book: Catalog Entry View All Images: All Images From Book Click here to view book online to see this illustration in context in a browseable online version of this book. Text Appearing Before Image: 222 CIECULATION OF THE BLOOD. (ch. VI. stroke and downstroke, because they are universally taken tomean the sudden injection of blood into the already full arteries,and the gradual fall of the lever signifying the recovery of thearteries by their recoil. These points may be demonstrated on asystem of elastic tubes, with a syringe to pump in water atregular intervals, just as well as on the radial artery, or on themore complicated system of tubes in which the heart, the arteries,the capillaries and veins are represented, which is known as an Text Appearing After Image: Fig. 185.—Diagram of the formation of the pulse-tracing, a, percussion -nave; b, tidalwave; c, dicrotic wave. (Mahomed.) arterial schema. If we place two or more sphygmographs uponsuch a system of tubes at increasing distances from the pump,we may demonstrate first, that the rise of the lever commencesearliest in that nearest the pump, and secondly, that it is higherand more sudden, while at a longer distance from the pump thewave is less marked, and a little later. So in the arteries of thebody the wave of blood gradually gets less and less as weapproach the periphery of the arterial system, and is lost in thecapillaries according to Mahomed. By the sudden injection ofblood two distinct waves are produced, which are called the tidaland percussion waves. The tidal wave occurs whenever fluid isinjected into an elastic tube (fig. 185, b), and is due to theexpansion of the tube and its more gradual collapse. The per-cussion wave occurs (fig. 185, a) when the impulse imparted tothe flui Note About Images Please note that these images are extracted from scanned page images that may have been digitally enhanced for readability - coloration and appearance of these illustrations may not perfectly resemble the original work.
context_page_description: Frederick Henry Horatio Akbar Mahomed was an internationally known British physician from Brighton, England.
context_section_description: In 1867, aged 18, Mahomed began to study medicine at the Sussex County Hospital, Brighton. Two years later in October 1869, he entered Guy's Hospital, London as a medical student. He was an outstanding student and, in 1871, won the student Pupils' Physical Society prize for his work on the sphygmograph, having been runner-up the previous year. Mahomed qualified as a Member of the Royal College of Surgeons in 1872. Following qualification, Mahomed worked at Highgate Infirmary (St Pancras' North Infirmary, Central London Sick Asylum) for a year. In 1873, he was appointed as resident medical officer at the London Fever Hospital in Liverpool Street, Islington. In 1874 Mahomed became a member of the Royal College of Physicians and was appointed as Student Tutor and Pathologist at St Mary's Hospital, Paddington. In 1875, Mahomed gained a doctorate (M.D.) from the University of Brussels. In 1877, he returned to Guy's Hospital as a Registrar (Senior Resident). He was elected as a Fellow of the Royal College of Physicians in 1880, and in 1881, he was awarded an M.B. from Cambridge University for his thesis on "Chronic Bright's disease without albuminuria". In the same year, he was appointed Assistant Physician at Guy's Hospital and, in 1882, he was appointed as a Demonstrator in Morbid Anatomy at Guy's Hospital.
  Mahomed‘s earliest contribution, while still a medical student, was to improve the sphygmograph, a device for measuring blood pressure that had originally been devised by Karl von Vierordt and further developed by Étienne-Jules Marey. Mahomed’s major innovation was to make the sphygmograph quantitative, so that it was able to measure arterial blood pressure (in Troy ounces). The description of the modified instrument was published in 1872. Following his graduation in the same year, Mahomed took up an appointment at the Central London Sick Asylum, where he worked with Sir William Broadbent, who became a strong supporter and friend. Several of Mahomed’s pulse tracings are contained in Broadbent’s classic book, The Pulse. Mahomed used the new sphygmograph to measure arterial tension (blood pressure) in Bright's disease and a range of other conditions, including pregnancy, scarlet fever, gout, alcohol and lead poisoning. He found that in some individuals blood pressure was elevated before there was evidence of kidney disease, assessed by measurement of protein in the urine (proteinuria). He also made the association between the elevated blood pressure and various post-mortem changes, including  enlargement of the heart (cardiac hypertrophy), thickening and fibrosis of the arterial wall, aneurysm formation, and damage to the microcirculation (arterio-capillary fibrosis). In effect, Mahomed was describing most of the key pathological effects of essential hypertension for the first time. Initially he termed this condition "Bright's disease without albuminuria" but later he described it as “high pressure diathesis”. His description of the condition is worth citing:
  ‘…the existence of this abnormally high pressure does not necessarily mean disease, but only a tendency towards disease. It is a functional condition, not necessarily a permanent one, though it is generally more or less so in these individuals. These persons appear to pass on through life pretty much as others do… As age advances the enemy gains accessions of strength; perhaps the mode of life assists him - good living and alcoholic beverages make secure his position, or head work, mental anxiety, hurried meals, constant excitement, inappropriate or badly cooked food, or any other of the common but undesirable circumstances of everyday life, tend to intensify the existing condition, or, if not previously present, perhaps produce it. Now under this greatly increased arterial pressure, hearts begin to hypertrophy and arteries to thicken; what has previously been a functional condition tends to become more of the nature of an organic one…’
  Mahomed also proposed that reducing blood pressure would prolong life, although the means of doing that  in his era were in the main l
caption: Diagram of the formation of the pulse (Mahomed)
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