73 



Reprinted from the British Medical Journal, August lllh, 

 and 18th, 1923. 



SOME APPLICATIONS OF PHYSIOLOGY 

 TO MEDICINE. 



II.— VENTRICULAR FIBRILLATION AND SUDDEN 

 DEATH.* 



BY 



J. A. MacWILLIAM, M.D., F.R.S., 



PROFESSOR OF PHYSIOLOGY IN THE UNIVERSITY OF ABERDEEN. 



(From the Physiological Laboratory.) 



It may be permissible to recall that in the pages of this 

 JouiiNAL^ thirty-four years ago I brought forward a new 

 view as to the causation of sudden death by a previously 

 unrecognized formi of failure of the heart's action in man — a 

 view fundamentally different from those entertained up to 

 that time. In the course of a long series of experiments on 

 the mammalian heart, sudden deaths, occurring under 

 varied experimental conditions, were found to be invariably 

 associated with a very definite mechanism of failure entirely 

 different in character from what had hitherto been believed 

 to be present in cases of sudden dissolution in man depending 

 on cardiac failure. Little attention was given to the new 

 view for many years. At that time the current conception 

 of the relations of the experimental physiology of the heart 

 to practical medicine was widely removed from what it now 

 is, thanks very largely to the work of Sir James Mackenzie 

 and his associates and followers; it was not then recognized 

 that most of the disturbances that have been experimentally 

 induced in the mammalian heart (for example, fibrillation, 

 flutter, heart-block, extra-systoles of various types, rhythms 

 of abnormal origin, alternation of the heart beat, etc.) have 

 their clinical counterparts in the manifold derangements of 

 function in diseased conditions in man. 



•Part I was publisbed in the British Mediqil Journal of January 13th, 

 J923 (p. 51). 

 [292'23] 



