( 84) 



lie doubtlessly stated. In the latter curves no registration of the 

 jugular vein was added to the ventricular curve, so that I am not 

 in the situation to suppose or deny for these curves the same origin 

 as in my curve. 



All in all it, seems to me, that in these curves and their analysis 

 we have important arguments, which tend to prove, that from the 

 physiological side more special research is needed regarding the 

 conduction within the individual divisions of the heart. For the first 

 of the four described types of P. A. we have shown, that from 

 physiological side the cause has to lie sought in changed conductivity 

 by which in the weak contractions, the contraction wave is limited 

 to a part of V. For the second type of P. A. we thought we were able 

 to bring direct proofs, while it became probable for the third type 

 of P. A., that they are results of the conduction between the sinus and 

 the ventricle becoming slower; and for the third form of P. A. it 

 appeared probable that the P. A. is the result of the antiperistaltic 

 contraction wave, so that we had here not a quantitative, but a 

 qualitative change in the conductivity. Regarding the fact which 

 •Trendelenburg stated, that by stimulating the ventricle artificially 

 the frequency of the ventricular rhythm may become much greater 

 if slowly the stimulation is quickened, before "Halbierung" of 

 the heart-beat, makes appearance, then if within a short period a 

 great frequency is attained, it is equally to be interpreted as follows : 

 that by slowly increasing frequency the conductivity is enabled 

 to adapt itself to the great demands ; so that the moment is 

 delayed where necessarily only partial contractions of the ventricle 

 arise. Regarding the pathology, it appears to me that it is of 

 importance for the knowledge of the pulsus trigeminus, discussed 

 by Wenckkbach, that from physiological side the importance of 

 dissociation of the ventricle under certain circumstances as also 

 the importance of the antiperistaltic contraction wave has been proved. 

 With the statement that partial contractions do occur, it appears to 

 me, that the necessity becomes evident, that the law of Bowditch 

 has to be limited, in so tar, that certainly every ventricular muscle 

 fibre which contracts, does so with maximum force; but on the 

 other hand, we have not to accept that necessarily in every ventri- 

 cular contraction all muscular bundles contract equally. 



Where we have to interprete curves like those of Tsciiirjew ') 

 (cited by Wenckebach) of <). Pan"), R. Finkelenburg 3 ) and Hay 



') Tschirjew. Archiv fur Physiologie. 1S77. 



-i Ü. Pan. Deutsche Zeitschrift. f. klin. Medizin. Bd. 78. 1905. p. 128. 



s ) R. Finkelenburg. Cited by Wenckebach. 1905. Heft 1 and 2. p. 586. 





