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much as it did while in the body. And careful attention to these pulsations will show that they consist of :-(1) A simultaneous contraction of the walls of both auricles. (2) Immediately following this, a simultaneous contraction of the walls of both ventricles. (3) Then comes a pause, or state of rest ; after which the auricles and ventricles contract again in the same order as before, and their contractions are followed by the same pause as before.

If the auricular contraction be represented by ATM, the ventricular by V", and the pauses by

the series of actions will be as follows : À V° — ; Ao V° - ; Ao V° - ; &c. Thus, the contraction of the heart is rhythmical, two short contractions of its upper and lower halves respectively being followed by a pause of the whole, which occupies about as much time as the two contractions.

The state of contraction of the ventricle or auricle is called its systole; the state of relaxation, during which it undergoes dilatation, its diastole.

12. Having now acquired a notion of the arrangement of the different pipes and reservoirs of the circulatory system, of the position of the valves, and of the rhythmical contractions of the heart, it will be easy to comprehend what must happen if, when the whole apparatus is full of blood, the first step in the pulsation of the heart occurs and the auricles contract.

By this action each auricle tends to squeeze the fluid which it contains out of itself in two directions—the one towards the great veins, the other towards the ventricles ; and the direction which the blood, as a whole, will take, will depend upon the relative resistance offered to it in these two directions. Towards the great veins it is resisted by the mass of the blood contained in the veins. Towards the ventricles, on the contrary, there is no resistance worth mentioning, inasmuch as the valves are open, the walls of the ventricles, in their uncontracted state, are flaccid and easily distended, and the entire pressure of the arterial blood is taken off by the semilunar valves, which are necessarily closed.

Therefore, when the auricles contract, only a very little of the fluid which they contain will flow back into the

veins, and the great proportion will pass into and distend the ventricles. As the ventricles fill and begin to resist further distension, the blood, getting behind the auriculoventricular valves, will push them towards one another, and almost shut them. The auricles now cease to contract, and immediately that their walls relax, fresh blood flows from the great veins and slowly distends them again.

But the moment the auricular systole is over, the ventricular systole begins. The walls of each ventricle contract vigorously, and the first effect of that contraction is to shut the auriculo-ventricular valves completely and to stop all egress towards the auricle. The pressure upon the valves becomes very considerable, and they might even be driven upwards, if it were not for the chordæ tendineæ which hold down their edges.

As the contraction continues and the capacities of the ventricles become diminished, the points of the wall of the heart to which the chorda tendinea are attached approach the edges of the valves ; and thus there is a tendency to allow of a slackening of these cords, which, if it really took place, mig permit the edges of the valves to flap back and so destroy their utility. This tendency, however, is counteracted by the chorde tendineæ being connected, not directly to the walls of the heart, but to those muscular pillars, the papillary muscles, which stand out from its substance. These muscular pillars shorten at the same time as the substance of the heart contracts; and thus, just so far as the contraction of the walls of the ventricles brings the papillary muscles nearer the valves, do they, by their own contraction, pull the chorda tendineæ as tight as before.

By the means which have now been described, the fluid in the ventricle is debarred from passing back into the auricle ; the whole force of the contraction of the ventricular walls is therefore expended in overcoming the resistance presented by the semilunar valves. This resistance has several sources, being the result, partly, of the weight of the vertical column of blood which the valves support; partly, of the reaction of the distended elastic walls of the great arteries, and partly, of the friction and inertia of the blood contained in the vessels.

It now becomes obvious why the ventricles have so much more to do than the auricles, and why valves are needed between the auricles and ventricles, while none are wanted between the auricles and the veins.

All that the auricles have to do is to fill the ventricles, which offer no active resistance to that process. Hence the thinness of the walls of the auricles, and hence the needlessness of any auriculo-venous valve, the resistance on the side of the ventricle being so insignificant that it gives way, at once, before the pressure of the blood in the veins.

On the other hand, the ventricles have to overcome a great resistance in order to force fluid into elastic tubes which are already full ; and if there were no auriculoventricular valves, the fluid in the ventricles would ineet with less obstacle in pushing its way backward into the auricles and thence into the veins, than in separating the semilunar valves. Hence the necessity, firstly, of the auriculo-ventricular valves ; and, secondly, of the thickness and strength of the walls of the ventricles. And since the aorta, systemic arteries, capillaries, and veins form a much larger system of tubes, containing more fluid and offering more resistance than the pulmonary arteries, capillaries, and veins, it follows that the left ventricle needs a thicker muscular wall than the right.

13. Thus, at every systole of the auricles, the ventricles are filled and the auricles emptied, the latter being slowly refilled by the pressure of the fluid in the great veins, which is amply sufficient to overcome the passive resistance of the relaxed auricular walls. And, at every systole of the ventricles, the arterial systems of the body and lungs receive the contents of these ventricles, and the nearly emptied ventricles remain ready to be refilled by the auricles.

We must now consider what happens in the arteries. When the contents of the ventricles are suddenly forced into these tubes (which, it must be recollected, are already full), a shock is given to the entire mass of fluid which they contain. This shock is propagated almost instantaneously throughout the fluid, becoming fainter and fainter in proportion to the increase of the mass of the blood in the capillaries, until it finally ceases to be discernible.

If the vessels were tubes of a rigid material, like gaspipes, the fluid which the arteries contain would be transported forward as far as this impulse was competent to carry it, at the same instant as the shock, throughout their whole extent. And, as the arteries open into the capillaries, the capillaries into the veins, and these into the heart, a quantity of fluid exactly equal to that driven out of the ventricles would be returned to the auricles, almost at the same moment that the ventricles contract.

However, the vessels are not rigid, but, on the contrary, very yielding tubes ; and the great arteries, as we have seen, have especially elastic walls. What happens, then, when the ventricular systole takes place, is-firstly, the production of the general slight and sudden shock already mentioned ; and, secondly, the •dilatation of the great arteries by the pressure of the increased quantity of blood forced into them.

But, when the systole is over, the force stored up in the dilated arterial walls, in the shape of elastic tension, comes into play and exerts a pressure on the fluid—the first effect of which is to shut the semilunar valves; the second, to drive a certain quantity of the

fluid from the larger arteries along the smaller ones. These it dilates in the same fashion. The fluid at length passing into the capillaries, the ejection of a corresponding quantity of Auid from them into the veins, and finally from the veins into the heart, is the ultimate result of the ventricular systole.

14. Several of the practical results of the working of the heart and arteries just described now become intelligible. For example, between the fifth and sixth ribs, on the left side, a certain movement is perceptible by the finger and by the eye, which is known as the beating of the heart. It is the result of the striking of the apex of the heart against the pericardium, and through it, on the inner wall of the chest, at this point, at the moment of the systole of the ventricles. When the systole occurs, in fact, two things happen : in the first place, as a result of the manner in which the muscular fibres of the heart are disposed, its apex bends upwards sharply; and, in the second place, its front face is thrown a little downwards and forwards, in consequence of the stretching and elongation of the aorta by the blood which is thrown into it.

The result of one or other, or both of these actions combined, is the upward and forward blow of the apex of the heart which we feel.

15. Secondly, if the ear be applied over the heart, certain sounds are heard, which recur with great regularity, at intervals corresponding with those between every two beats. First comes a longish dull sound ; then a short sharp sound ; then a pause; then the long, then the sharp sound, then another pause ; and so on.

There are many different opinions as to the cause of the first sound, and perhaps physiologists are not yet at the bottom of the matter ; though the more probable view is, that part of it is a muscular sound caused by the contraction of the muscular fibres of the ventricle, and part is due to the tension of the auriculo-ventricular valves ; but the second sound is, without doubt, caused by the sudden closure of the semilunar valves when the ventricular systole ends. That such is the case has been proved experimentally, by hooking back the semilunar valves in a living animal, when the second sound ceases at once.

16. Thirdly, if the finger be placed upon an artery, such as that at the wrist, what is termed the pulse will be felt ; that is to say, the elastic artery dilates somewhat, at regular intervals, which answer to the beatings of the heart. The pulse which is felt by the finger, however, does not correspond precisely with the beat of the heart, but takes place a little after it, and the interval is longer the greater the distance of the artery from the heart. The beat in the artery on the inner side of the ankle, for example, is a little later than the beat of the artery in the temple.

The reason of this is that the sense of touch by finger is only delicate enough to distinguish the dilatation of the artery by the wave of blood, which is driven along it by the elastic reaction of the aorta, and is not competent to perceive the first shock caused by the systole. But if, instead of the fingers, sufficiently delicate levers were made to rest upon any two arteries, it would be found that the pulse really begins at the same time in both, the shock of the systole making itself felt all over the vascular system at once; and that it is only the actual dilatation of the arterial walls, which, travelling in the form of a

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