( 81 ) 



way, that a completer sinus and auricular contraction tends to give 

 rise to a completer ventricular contraction. If so, the next problem 

 appears to he, whether this relation is kept up by special muscular 

 arrangements or else whether nervous and ganglionic influence may 

 play a role in it. 



Third Form of P.A. with retarded smaller contraction. 



Figure 3 is an example, where we find moreover reappearance of 

 normal pulsation. Simple inspection of the pulsating heart made already 

 the impression, that we had to deal with an antiperistaltic contrac- 

 tion; that the contraction-wave reaching the ventricle from the auricle, 

 returned again to the auricle. Brandenburg l ), also Pan '), Hering '), 

 Volhard a ), and Schmoli. s ) have observed antiperistaltic contraction, 

 after the writer had long ago shown '), that antiperistaltic contrac- 

 tions are a very constant phenomenon in the sinus of the turtle-heart. 



In this case of fig. 3 we have to deal for the interpretation with 

 '2 possibilities, 1. we may have to do with a real extra-contraction 

 of auricle and ventricle, which results only in a very small elevation 

 of the lever, because of its appearing in the-beginning of the diastole, 

 the ventricle being in the refractory period ; or secondly we have 

 to do with an antiperistaltic contraction wave, which on account of 

 insufficient restoration of' conduction in the A — I" bundle and the 

 ventricular musculature, can only give rise to a weak I",. 



Indeed, the first supposition could not be discarded if it were to be 

 admitted that spontaneously under similar conditions in the frog such an 

 extra- A s , followed by a very weak V s could occur ; an extra-contrac- 

 tion, which moreover was followed by an uncomplete compensatory 

 pause. This conception is however hardly acceptable, if we take note 

 of the systematical mode, in which this P. A., so to say, is prepared 

 by the two abnormal contractions, which precede the very small V s . 

 Because these changes in (he two ventricular contractions occur 

 regularly at least in so far, as in my curves I come across similar 

 cases, I think, that the other interpretation gains considerably in 

 probable correctness. This supposition is therefore as follows: Under 

 influence of the drug the conducting power within the ventricle is 



'; K. Brandenburg Arch. f. Anat. u. Physiol. Abt. 1904. Supp. p. 216. 

 "-) 0. Pan. Deutsche Zeitschr. f. klin. Medizin. Bd. 78. 1903. p. 128. 

 3 ) Hering. Pflüger's Arch. Bd. 82. p. 1. 

 *) Volhard. Zeitschr. f. klin. Medizin. 1904. Bd. 53. p. 574. 



5 ) Schmoll. Arch. f. klin. Medizin. 1907. p. 507. 



6 ) Ned. Tijdschr. v. Geneesk. 1898. Deel II. Biz. 568 and Americ. Jnl. of Phy. 

 siology; Vol. I. 1898. p. 504. 



