92 PULSE RECORDS IN THEIR RELATION TO 



this chamber is alone in contact with the gullet. Rautenberg 

 has attempted to defend his position by taking tracings in animals 

 from the oesophagus, simultaneously with others from the right 

 auricle, the apex beat or jugular vein. But his tracings do not 

 offer convincing evidence, and necessitate the assumption that the 

 apex beat is long delayed, an assumption which is not borne out 

 by the simultaneous tracings from apex beat and oesophagus. It 

 must be admitted that the auricular contraction may give a 

 negative curve, and if at the same time it is to be recognised that 

 a positive curve may result, the possibility of intermediate types, 

 half negative and half positive, introduces serious difficulties into 

 the interpretation of the tracings. The same problem arises in 



the case of those curves obtained 

 from the auricle through the chest 

 wall. Erlanger's curves taken from 

 the auricle, and already referred to, 

 show the auricular waves inverted, 

 while Rautenberg's curves ( 42d ) re- 

 corded in a similar manner are in- 

 FIG. 2. terpreted as showing a convex wave. 



Here again there is the necessary 



assumption of delay in the appearance of the apex beat, some- 

 times amounting to '1 sec. An illustration (Fig. 2 of this article), 

 based on one of Rautenberg's curves ( 42d ) (No. 2), will make this 

 point clearer. The upper curve is from a point on the chest wall 

 overlying the right auricle ; the lower curve is from the apex 

 beat. Four corresponding points have been marked on the 

 curves, the upper of which is open to two interpretations. 

 According to Rautenberg, auricular contraction is represented 

 by a-c, and there is a delay, cd, between the commence- 

 ment of systole and the upstroke of the cardiogram. On the 

 other hand, it may justly be argued that the contraction of the 

 auricle is represented by bd, and that the curve is inverted ; 

 and this view receives confirmation from two sources. In the first 

 place, other observers do not find delays in the upstroke of the 

 cardiogram of a nature comparable to those given by Rautenberg ; 

 and secondly, Rautenberg's cardiographic curve itself shows a rise 

 which can only be attributed to the auricular wave, namely, at b. 

 In view of the argument which might be raised, that the auricular 

 wave is delayed, it would perhaps be safer to await further work 



