An observation relating to the nature of auricular fibrillation / by Thomas Lewis.

  • Thomas Lewis
Date:
[1913]
Catalogue details

Licence: Public Domain Mark

Credit: An observation relating to the nature of auricular fibrillation / by Thomas Lewis. Source: Wellcome Collection.

    4/10 page 274
    274 Tl. LEWIS. But suppose the water in the same pool to be disturbed at a large number of separate points (Fig. 2), so that the whole surface is lashed into innumerable waves and ripples, travelling in many directions. What happens at the outlet? If this be sufficiently narrow the separate outgoing waves will be of the same form as before ; the general line of each will be at right angles to the stream, and after the immediate outlet is passed they will no longer clash but will pursue each other in parallel course along the length of the stream. Nevertheless their succession will be a perfectly irregular one. Such I imagine to be the analogous conditions when the auricle is fibrillating. Fig. 1 and 2. Diagrams, illustrating the writer’s conception of the paths taken by the contraction waves in the auricle. 1, while the auricle beats co-ordinately and 2, while it fibrillates. The hypothesis has suggested a simple experiment. If it be correct, then the reason why the A-V bundle fails to convey fibrillation from one chamber to another is that it is a narrow channel. Fig. 3. A diagram of the right auricle, showing the positions (1 and 2) in which the clamp is appled to the base of the appendix. Pa—-pacemaker. For the purpose of the corroborative experiment, I have used dogs, anzsthetised with morphia, paraldehyde and ether. The heart is exposed and a fine suture run under the epicardium at the tip of the auricular appendix. Stretching the appendix, a strong clamp is applied across its base (Fig. 1), at such pressure as to break the softer muscular tissue without destroying the stronger epicardium and endocardium; the success of the crush is indicated by the transparency of the tissues directly after the clamp is
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