The Heart Station
During the period when Dr. A. W. Hewlett held the chair of medicine at the University (1908-16) there was widespread interest in the irregularities and other abnormalities of the heartbeat, and knowledge in this field was expanding very rapidly. Dr. Hewlett himself had made important contributions to this subject, and Dr. J. G. Van Zwaluwenburg was also deeply interested in it. As soon as the necessary funds could be obtained Dr. Hewlett purchased a string galvanometer, and electrocardiograms were taken for the first time at the University Hospital in the spring of 1914.
Dr. Frank N. Wilson, who was appointed Assistant in the Department of Internal Medicine upon his graduation with the class of 1913, was assigned the task of installing and operating this instrument. Since no other space was available it was placed in Dr. Hewlett's private office, a small room separated by a thin wooden partition extending half way to the ceiling from the general office of the department, which was on the second floor of the Medical Wing of the Old University Hospital. The electrocardiographic tracings were carried downstairs, where a tiny darkroom was available for their development. In spite of these meager and inconvenient facilities, many interesting observations were made and a number of papers were published. With Dr. Hewlett's help arrangements were made for recording the venous pulse, taken with a Frank capsule, simultaneously with the electrocardiogram, and this added greatly to the value of the tracings. One of the most important studies carried out dealt with the production of atrioventricular rhythm in normal subjects after the administration of atropin.
In 1916 both Dr. Hewlett and Dr. Wilson left Michigan and during the next four years relatively few tracings were taken. When Dr. Wilson returned to Ann Arbor in 1920 the equipment had been removed from its old location. It was not in good working order, and there was no available space where it could be installed. Nothing further was done until 1922 when Dr. George Herrmann, a Michigan graduate, joined the staff. At that time, with the help of Dean Vaughan, a special appropriation was obtained which made it possible to purchase new equipment and to construct a small laboratory where it could be set up. This laboratory included a small passageway and some space beneath the stairs leading to the medical amphitheater. As a result many of the waves on the tracings obtained were produced, not by the patient's heartbeat, but by the students rushing to and from their classes. In the early summer of 1922, when this new laboratory was completed, Sir Thomas Lewis of London visited the University, and this visit did a great deal to stimulate interest in electrocardiography.
In order to defray the expense of operating the new laboratory, the Hospital made a charge for each clinical electrocardiogram taken. A technician, Miss Evelyn Turner, was secured, and she soon became expert at operating the galvanometer. During the next three years about 4,500 electrocardiograms were taken and several research projects were carried out, among which may be mentioned Dr. Herrmann's studies on ventricular hypertrophy.
When the new University Hospital was under construction, arrangements were made for a wiring system whereby it became possible to take an electrocardiogram on any patient in the Hospital without making it necessary for the patient to leave his bed. In 1924 Professor Willem Einthoven visited Ann Arbor, and negotiations were begun with him at that time for the construction in Holland Page 989of a new galvanometer which would make it possible to take two electrocardiographic leads simultaneously. After much delay this galvanometer, which was actually constructed in Einthoven's laboratory, was obtained in the summer of 1927. It proved to be a wonderfully fine piece of apparatus, and much of the research work carried out in the Heart Station since that time could not have been done without it.
The Heart Station was moved to the new Hospital in the autumn of 1925. Dr. Herrmann was succeeded by Dr. Paul S. Barker. The additional help, space, and equipment made it possible not only to serve the Hospital more adequately, but also to do research which has been of the utmost importance. Studies of the distribution of the electrical currents produced by the heartbeat within the body, of the electrocardiograms produced by human bundle branch block, of precordial leads, of the areas of the electrocardiographic deflections, and of experimental and clinical coronary occlusion may be mentioned.
In 1932 Dr. Franklin D. Johnston joined the staff. He not only has taken an active part in many of the studies already mentioned, but also has done a great deal of work on the registration of heart sounds and on the adaptation of the cathode-ray oscillograph to the study of the electrocardiogram.