NATURE 



451 



THURSDAY, FEBRUARY 18, 1901). 



APPI.IED PHYSIOLOGY OF THE 

 CIRCUL.ITIOX. 

 '] llcrat>^•llti^■s of the Circulation : luglit Lccliircs de- 

 livered ill the Spring of 1905 in tlic Physiological 

 Laboratory of the University of London. By Sir 

 Ljuider Brunton, Bart., F.R.S. Pp. .\ii + 272. 

 (London : John Murray. igo8.) Price 7^. 6d. net. 



PERHAPS there is no department of the healing 

 art in which the vivifying and reconstructing 

 influence of physiology and of laboratory methods is 

 more apparent than in that devoted to the study of 

 disorders and diseases of the circulation. Of this 

 position the recently published volume of lectures by 

 Sir Lauder Brunton affords an e.xcellent illustration, 

 for all through its pages we see how physiology aids 

 the physician, not only in clarifving his conceptions of 

 clinical facts, but in applying and inspiring his treat- 

 ment of circulatory ailments. 



For the execution of the work the author posse-ses 

 the happy combination of advantages derived from his 

 early laboratory training under the celebrated Ludwig, 

 from his life-long love of physiology, and from his 

 extended experience as a clinical worker and teacher. 

 It has been said that the physician is — or should be 

 -a physiologist and something more; and that 

 " something more " is the practical quality of apply- 

 ing, not only his pathological, but also his phvsio- 

 logical data to the work of the hour. The dominance 

 of that quality in the author's handling of the material 

 of his lectures is a prominent feature of the volume. 



In the earlier lectures we have an exposition of 

 the physiology of the circulation. The clear and 

 comprehensive description of the forces at work will 

 be appreciated, not only by professional readers — 

 wliether physiologists or clinicians — but by those 

 members of the community who take an interest in 

 the study of physiological subjects. Moreover, even 

 the medical reader fairly conversant with clinical work 

 on the circulation may, by the perusal of these lectures, 

 gain something in the clearness of his conception of 

 the fundamentals presented by an author who has 

 the gift of exposition and happy illustration. 



In the first lecture we have a description of the 

 parts played by the heart, the arteries, capillaries and 

 veins, the vaso-motor system of nerves, and the acces- 

 sory aids to the circulation furnished by the fascis 

 .ind muscles; these and cognate topics are discussed 

 under such headings as sleep of the heart, motor 

 and peristaltic action of arteries, accessorv muscles 

 of the circulation, arterial tension or blood-pressure 

 and its regulation, the influence of the muscular and 

 splanchnic areas, depressor nerves, independent pulsa- 

 tion of veins, &c. 



But the physiologist and pathologist will be more 

 particularly attracted to that portion of the lecture 

 which is devoted to the study of the point of origin 

 and the conductivity of the impulse which culminates 

 in the contraction of the ventricle, a subject which 

 has, especially of late years, fascinated the pathologist 

 as well as the physiologist — for it affords the kev to 

 NO. 2051, VOL. 79] 



the irregularitv of the heart's action, and to the disso- 

 ciation of the auricular and ventricular contraction. 

 It is now some twenty-five years since Gaskell demon- 

 strated the continuous track of the impulse from the 

 venous sinus, in which it originates, to the auricle, 

 and from the auricle to the ventricle ; and the sound- 

 ness of this physiological conclusion has since been 

 confirmed by the work of Stanley' Kent, W. His, jun., 

 and more recent workers (such as Tawara and Keith), 

 who have established the existence of a specialised 

 muscular tissue possessing neuro-muscular properties, 

 which forms the anatomical basis of the track fol- 

 lowed bv the impulse from the sinus to the ventricle. 

 In introducing this subject the author cites the work 

 of Romanes on the medusa, a polyp which is cir- 

 cumscribed bv a bell-shaped piece of contractile 

 protoplasm margined by a nervous gangliated chain 

 and a fringe of mobile tentacles. This work, though 

 executed some few years before that of Gaskell, forms 

 a happv illustration of the broad results of the 

 inquirv into the conductivity in the heart muscle, and 

 will well repay perusal. 



Sorne recent workers hold that it is an inherent 

 propertv of the heart muscle to originate and conduct 

 the stimulus which causes the heart to beat, they 

 regarding this function as independent of the nervous 

 ganglia and the nerve fibres in the heart. The author 

 is not one of these. He says, referring to his work 

 with Cash : — 



" These experiments, which were not only very 

 numerous but very varied, seemed to us to show that, 

 just as in a medusa, there are in the heart two distinct 

 channels, the nervous as well as the muscular, by 

 which stimuli are conducted from one part of the 

 heart to another, and that the nervous conduction may 

 interfere with the muscular conduction " (pp. 32-4). 



Furthermore, he points out that " the importance 

 of the cardiac ganglia in originating the beats of the 

 heart has been prominently brought forward since 

 these lectures were given, by Dogiel and Arch- 

 angelsky, Pfiilger's Archiv, July, 1906" (p. 30); that 

 " Kronecker and Imchanitzky have shown that the 

 bundle of Stanley Kent and His (connecting the 

 auricles and ventricles) can be ligatured without dis- 

 turbing the coordination between the auricles and 

 ventricles" (p. 225); and that Paukul has found 

 nervous plexuses in that bundle, " injury of which 

 disturbs coordination, while ligature of the muscular 

 part of the bundle does not impair coordination " (p. 



-'25). 



In connection with this subject, the reader will also 

 find further interesting matter in the appendices 

 .\ and D. In appendix .\ the author treats on the 

 conduction of stimuli and the contractility of organic 

 tissues allied to that of the fibres of His and Pur- 

 kinji in the heart — such as contractile vegetable 

 protoplasm (producing the movements of plants), con- 

 tractile animal protoplasm (amoeba, leucocytes), neuro- 

 muscular cells (fresh-water hydra). Appendix D is an 

 epitome of an interesting contribution by the author's 

 old friend and fellow-worker of nearly forty years ago 

 in Ludwig's laboratory. Prof. Kronecker, of Berne, 

 who lias done so much to advance our knowledge 



R 



