54 



cond, The tracing shows a succession of 

 exfrasystoUc beats recurring alternatively 

 with normal cycle. The derivation R is bi- 

 fid. 5 appears in this deviation and T leaves 

 of being inverted. The extrasystoles are of 

 ventricular origin, probably from the righe 

 ventricle . The deviations P keep their rhythint 

 marked in the diphasic variation of the extra- 

 systoles. 



Observation no. 63. 



F. Mor., mulatto, male, 30 years old, 

 married, laborer, resident in the nejo-hbor- 

 hood of Lassance. 



Examined April 13, 1921 . 



Is of medium height, well-built and of 

 robust appearance He did not come to 

 consult a doctor and was only examined 

 as he had a daughter under our carp, who 

 had an acute form of trypanosomiasis, with 

 numerous parasites in the peripheral blood 

 He lives in a house infested with infected 

 triatomes. Previous history: nothing worthy 

 of notice. There are no subjective symptoms 

 except rather easily brought on fatigue, and 

 sometimes lapse of the pulse, though he did 

 not pay much attention to this. The object- 

 ive examination reveals a slight increase of 

 the cardiac area, and numerous extrasystoles, 

 without other perceptible alterations of 

 circulatory system. Thyroid enlarged, with 

 hard cysts of different sizes not being bigger 

 than a walnut. The examination of other 

 systems proved negative. 



Complen7ent fixation reaction positive 

 (with heart of a dog infected by Tryp. Cruzi 

 as antigen). 



Several electrocardiagraphic tracings 

 were taken; we give Ns. 3, 4, 5 and 5a. 



Electrogram no. 3 was made with de- 

 rivation I. T=V5o"; 1 cm.=O.Oül volt. Two 

 extrasystoles are seen on the right side of 

 record, which interrupt the regular succes- 

 sion of the heart beats. In the beats of the 

 normal cycles are marked waves P, Q, R, 

 and 7". The space P Q is normal. T is in- 

 verted in all the cycles; S does not show. 

 The waves P succeed each other regulary; 

 they are seen in the extrasystolic variation 

 where they are marked. The extrasystoles 

 are ventricular and come from the right 

 ventricle. Record no. 4 came from patient 

 taken in derivation II (right arm -left leg). 

 Two extrasystoles are seen on the left of 

 the record, both probably originating in the 

 right ventricle. In the beats of the normal 

 cycles it may be seen that Pis frankly bifid. 

 In the cycle which follows the second extra- 

 systole P is inverted, without there being 

 premature auricular contraction. Tis invert- 

 ed in all the cycles. It is clearly more mark- 

 ed in the cycles which follow the extrasyst- 

 olic beats which is a common fact. S is 

 deeper in this derivation, and that corresp- 

 onds to the predominance of V E. Records 

 5 and 5-A were taken at the same time as 

 the former ones but in D III. P is much 

 more elevated ; it is still bifid . The PP 

 waves are arrhythmic. S is less deep. T still 

 appears inverted. In both the records are 

 seen extrasystoles of ventricular origin. The 

 last of both the records comes from the left 

 ventricle, the others come from the right 

 vntricle. 



