1890.] Papillary Muscles of the Heart 79 



knowledge endeavoured to obtain a simultaneous record of the 

 work performed by these two portions of the cardiac muscle — nor 

 has the probability that the two have different periods of action 

 become in any way a part of general medical doctrine. Doubtless 

 physiologists and medical men have voluntarily neglected to 

 attempt exact observations upon this subject, from their knowledge 

 that it is almost impossible satisfactorily to solve what would seem 

 to be a much more simple matter, — the relation in time of the 

 contraction of the muscle of the base and of the apex of the ven- 

 tricle. And thus it has come to pass that nothing has been 

 accomplished in what Professor Roy and I now find to be a field 

 for research yielding suggestive, if not rich and important results. 



Without the aid of diagrams it would be difficult and tedious 

 to describe fully the apparatus employed by us in our work upon 

 this subject, but some idea may be given of the mechanism of our 

 instrument. In order to understand as fully as possible the nature 

 of the papillary contraction it is necessary to gain at the same 

 time a tracing of the contraction of the ventricular wall, so that 

 the relation in time of the different portions of either curve 

 obtained may be interpreted in terms of the other. We found 

 that the most satisfactory means of recording the ventricular wall 

 contraction was as follows. Taking two points upon the anterior sur- 

 face of the left ventricle, one near to the apex, the other nearer to 

 the base, to the former was attached a light but firm rod, moving 

 easily upon an axis so as not to prevent or modify the general to- 

 and-fro movement of the heart ; into the latter was inserted a hook 

 having a long shank, and these two parts of the instrument were 

 connected in such a way with each other, and by means of a fine 

 thread with the recording lever, that approximation of the two 

 points upon the cardiac surface, that is to say, contraction of the 

 muscle of the ventricular surface, resulted in an upward movement 

 of the lever point ; separation and cardiac dilatation, in a down- 

 ward movement. 



If now the light rod forming one limb of the above arrange- 

 ment were attached to the surface of the ventricle over the 

 region of insertion of one of the papillary muscles, a record 

 of the contraction of this muscle could be simultaneously ob- 

 tained by fixing on to the rod a cross-bar having at its further 

 extremity a pulley, round which passed a fine thread, attached at 

 one end to a second lever, and at the other to a strong hooked 

 wire pulling upon one of the flaps of the mitral valve, and by this 

 means upon the papillary muscle. To gain this attachment it was 

 necessary to clamp off temporarily the left auricular appendix 

 from the rest of the auricle, to make a small incision through its 

 walls, to pass into this incision the hooked wire, to ligature the 

 collar, in which the wire worked, to the wall of the appendix, and 



