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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    functions of the heart as mutually independent. It would of course be easier for clinical work if one had not to bother oneself with all these physiological details, and it is therefore not surprising that Hering's view has been taken up by clinicians. Thus F. Kraus ^^'^^ expressed the opinion in a speech which he recently delivered at the opening of the second medical clinic in Berlin, that my attempts at a clinical analysis of the irregular pulse do not appear to be quite successful, and said further:— The theory of H. E. Hering, according to which the changes in the excitability, contractility, and conductivity of the same muscle fibres in one part of the heart under natural pathological conditions occur as a rule in the same direction, furnishes us, I think, with a more simple key to the problem. After the detailed account which has been given, one can only say that the simplicity of the key is not of such importance as what can be opened with it, and that if any one is really willing to take up the analysis, he will be compelled to investigate the heart's action in all its details, and not merely resort to collective terms. § 10. Objections to the Myogenic Theory.-^The passion and the controversy that at first arose over this theory of the heart's action have now almost completely died away. But there are still two bitter opponents left, viz. Kronecker and von Cyon, two scientists of the highest repute, who have lately raised their voices against the theory of Engelmann. Kronecker ^^^^ opposes the myogenic theory in the paper, which he read at Hamburg, for various reasons, and amongst others that of the complete separation of the musculature of the auricle from that of the ventricle: a muscle-bridge, however, has been conclusively proved to exist by numerous investigators, and again recently by W. Ewald, ^^^^ who instituted a fresh research into the conduction of stimuli between auricle and ventricle. Moreover, Kronecker's puncture into the upper third of the ventricular septum of a dog's heart is continually being trotted out as a proof against the myogenic theory. But the fact that thiS' phenomenon has never yet been fully explained gives no more proof for the neurogenic theory than it does against the myo- genic, and after the latest explanation, Avhich Kronecker himself gives (loc. cit., p. 55) of it, that there is here a nerve centre, the stimulation (and injury ?) of which makes the coronary arteries contract and therefore produces anaemia of the wall of the heart,