Arhythmia of the heart : a physiological and clinical study / by K. F. Wenkebach ; translated by Thos. Snowball.

  • Wenkebach, Karel Frederik, 1864-1940.
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: Arhythmia of the heart : a physiological and clinical study / by K. F. Wenkebach ; translated by Thos. Snowball. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    The study of the physiology of the cell during the past year tends to make it more and more probable that these functions are associated with atoms difterent in their composition and separate from each other in space, as Engelmann had declared long before. And recently ^'^^ Engelmann has fully demonstrated that excita- bility {Anspruchsfdliigkcit) and the capacity for Avork (Leistungs- fdliiglxeit) are certainly different from one another. The stimulus and the power to respond to stimulation {Eeizbarheit) must also be separated as two totally different things; and he has shown from numerous examples that in the capacity for work the contrac- tility which performs the work is in its nature quite distinct from the excitability on the one hand and from the conductivity on the other. While investigating the duration of the refractory phase by means of the method of extra-systole, Engelmann was struck with the fact that the contractility and conductivity are not restored at the same rate after each systole. He demonstrated that the heart may completely lose its contractility and yet retain its conductivity by saturating a portion of the wall with distilled water, when he completely abolished the contractility in that part, while the conductivity remained unchanged. From further experiments it follows that these functions, tO' quote Engelmann's own Avords, ^^^^ have a certain mean action under normal conditions of life, e.g. temperature, metabolism, mechanical variations, nervous influences, &c., and change in the same direction, \^ith variations in these normal conditions; but yet, under certain circumstances, they may also vary in- dependently of each other, and even in an opposite manner at the same time. This fact is theoretically of much greater importance than that of their simultaneous activity or usual variation in the same direction, for it proves that the latter relationship need not necessarily exist, and therefore the three properties of stimulation, conduction, and contraction do not make up one single function, but represent processes distinct from each other in space and time. He then goes on to compare the organs that are capable of stimulation to musical instruments, of which there are some which are easy to make sound, but even with the greatest efforts give only a weak note, others that are difficult to play and yet emit a loud sound, while there are others again easy to play and possessing con- B