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THE DISCOVERY OF THE CARDIAC CONDUCTION SYSTEM: THE TESTIMONY OF THE AUTHORS WALTER EHRLICH* Introduction In the English medical literature, Keith and Flack [1] are often given credit for the discovery of the sinus node (see for instance Marshall [2]) and even for initiating "a major advance in our understanding of the heartbeat." Some non-English textbooks, however, contain different opinions. In Spalteholz's Handatlas of Human Anatomy [3], for instance, Tawara's name is given to the atrioventricular node and no other name is mentioned, whereas Tawara as well as Keith and Flack are cited in Rauber and Kopsch's Lehrbuch der Anatomy [4]. I also remember distinctly that as medical students at the Charles University in Prague before World War II, we learned that the sinus node was discovered by Aschoff and Tawara. The sinus node was, in fact, referred to as the AschoffTawara node, while the atrioventricular node was called Keith-Flack node, and its discovery was credited to Keith and Flack. I do not know whether we learned this from books or only from lectures. Although I cannot now find this version of events in any book we might have used at that time, the fact that such a version did exist is supported by Diego Rivera's mural in the Heart Institute in Mexico City. We do not know whether the version taught in Mexico when the mural was painted was the same as the version taught in Prague before the war, or whether The author acknowledges the support of Dr. E. T. Morman, Curator of the Historical Collection of the Institute of History of Medicine, Johns Hopkins University. The detail of the mural by Diego Rivera was photographed from the official colored reproduction of the mural issued by the Heart Institute in Mexico City. The photo of Dr. Tawara was kindly provided by Dr. Katsuo Sueishi, who is the present professor of Pathology at the University of Kyushui, a position formerly occupied by Dr. Tawara. Dr. Mitsuru Munakata of the Hobkeido University and Dr. Hisamishi Aisawa directed our search to Professor Sueishi. We are grateful to all three scientists. ?Physiology Division, School of Hygiene and Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, Maryland 21205.© 1992 by The University of Chicago. AU rights reserved. 003 1-5982/92/3504-079 1 $0 1 .00 Perspectives in Biology and Medicine, 35, 4 ¦ Summer 1992 487 Fig. 1.—Portion of mural by Diego Rivera. the mural was influenced by Central European scientists who lived in Mexico during the war and cooperated at the development of the Heart Institute. We show here the portion of the mural dedicated to the cardiac conducting system (Figure 1) in order to show that the version of events I vividly remember really did exist, and also because it presents portraits of some of the scientists whose work we discuss in this study.1 In the upper left-hand corner, the German pathologist Ludwig Aschoff (1866-1943) is pointing to a heart. To the right, a man with black hair is facing Aschoff and is pointing to a drawing of the sinus node, implying that Aschoff is demonstrating the sinus node and that the two men together had discovered this structure. "Tawara" is written above the man, who is seen only from the rear. This seems to indicate, first, that Rivera's scientific advisors believed that the Japanese scientist played a secondary role in the discovery and, second, that the painter 1On the second mural of Diego Rivera in the Heart Institute, the portrait of Dr. Karel Frederick Wenckebach is shown in the group of scientists who contributed to the understanding of the heart rhythm. The likeness of Heinrich Ewald Hering is found in many publications, also in the "Gallerie hervorragender Ärzte und Naturforscher," published as Beilage zur Münchener Medizinischen Wochenschrift in 1940. We were not able to find a portrait of Dr. Sunao Tawara in the medical literature. We believe therefore, that it is important to publish the photo of this scientist. 488 Walter Ehrlich ¦ The Cardiac Conduction System did not have access to a portrait, the first name, or the dates of Sunao Tawara (1873-1952). To...

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Additional Information

ISSN
1529-8795
Print ISSN
0031-5982
Pages
pp. 487-498
Launched on MUSE
2015-01-07
Open Access
No
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