Table of Contents
Significant Events in the 1930s:
- 1930: Dashiell Hammett-Publishes "The Maltese Falcon"
- 1930: Landsteiner receives Nobel Prize for human blood grouping
- 1931: All German Banks close/Britain abandons the Gold Standard
- 1935: Gerhard Domagk announces the discovery of first sulfa drug to treat streptococcal infection
- 1939: Germany Invades Poland-World War II Begins
Back to Top
Hyman Pacemaker 
In 1930 Albert S. Hyman decided on the need to resuscitate persons whose hearts had entered standstill. He did not distinguish between cardiac arrest and ventricular fibrillation and his published articles did not discuss heart block. He had previously described the use of intracardiac (right atrial) injections of many medications, including epinephrine. Among the techniques he also devised was a machine to produce electricity to be introduced into the heart by a needle plunged through the chest wall, and would cause it to beat. With his brother, an engineer, they developed and patented the "artificial pacemaker" operated by a hand crank and spring motor which turned a magneto (DC current generator) to supply the electricity. The device was used in the New York area and received press coverage, though not acceptance by the medical community. The concept was also criticized as interfering with natural events. He would not have it manufactured locally, a battery operated version was eventually manufactured by Siemens and is lost to history, though that version was tested and unfavorably reported upon in Germany. During the Second World War, Hyman unsuccessfully urged the U.S. Navy to support his device for use in resuscitation of dying servicemen.
Hyman AS. Resuscitation of the stopped heart by intracardial therapy. II Experimental use of an artificial pacemaker. Arch Intern Med 1932; 50: 283-305.
Back to Top
The Hyman II Pacemaker 
During his active promulgation of the artificial pacemaker (a term he coined) Albert S. Hyman claimed to have designed and had constructed several different models, although only a single model was ever described, or a photograph of which (Hyman AS. Resuscitation of the stopped heart by intracardial therapy. II Experimental use of an artificial pacemaker. Arch Intern Med 1932; 50:283-305) published in the medical literature. A photograph of another model without any description had been found. It was that of a clearly portable unit which presumably had been manufactured by Siemens, the parent company of Adlanco, in their German plant. It had been long assumed that this unit was manufactured during the late 1930s in order to test the potential for greater commercial exploitation, but had not been continued, as a consultant to Siemens had determined that the pacemaker would not accomplish its intended function and that all actual models built had been destroyed during World War II. Surprisingly, a copy of Popular Science of October 1933 was found by chance, containing a single page article concerning the Hyman pacemaker with a photograph of Hyman's engineer brother, Charles, "resuscitating" a young man. In the background is the pacemaker thought to have been manufactured only years later.
From this article the date of manufacture must have been sometime during 1932-1933. The one other photograph extant is so clear that the labels on the dials can be read and interpreted as they were in an article about the reconstruction of the Hyman I pacemaker by the NASPE history project (Furman S, Jeffrey K, Szarka G. The Mysterious Fate of Hyman's Pacemaker. PACE 2001;24:1126-1137). With the knowledge gained from the reconstruction of the earlier device and the information concerning the function of each of the dials in the "orphan" photograph, the second device was also reconstructed as a working model. Unlike the earlier model which is hardly portable, weighing XX kilograms, the portable Hyman II weighs YY kilograms, has a carrying handle and was intended to be brought to the site of use. The size of the device was estimated from the size of the handle, obviously intended to be operated by a human hand.
Both models are "working" in the sense that movable parts do move and for the Hyman II the small electrical output Hyman intended, incapable of causing a cardiac response, is emitted. From analysis of the electrical outputs of both Hyman devices it should not be expected that either would have been capable of resuscitating any asystolic mammalian or human heart.
The photograph shown is the original and may be compared with the reconstructed device. Many years later, after the invention of pacing, as it is known today, Albert S. Hyman was interviewed by historian David Schechter and quoted in his book (Schechter DC. Exploring the Origins of Electrical Cardiac Stimulation. Medtronic, Minneapolis, MN 1983). Hyman claimed to have resuscitated a patient in complete heart block with his "pacemaker" during his (Hyman's known) service in the U. S. Navy Medical Corps during the Second World War. None of those whom he stated witnessed the event ever mentioned it. The event is not otherwise recorded in the medical literature and no one remains alive. No records seem to exist.
Both these devices are the first known to bear the name artificial pacemaker and to have been specifically built and designed for cardiac resuscitation during asystole.
 |  |
| Popular Science, October 1933 | The only photograph extant of the Hyman Portable Pacemaker |
Back to Top
Bundle-Branch Block with Short P-R type Interval in Healthy Young People Prone to Paroxysmal Tachycardia
Aberrant ventricular complexes of the type generally recognized as indicating bundle–branch block were first produced by Eppinger and Rothberger by experimental division of the right branch of the His bundle. Eppinger and Stoerk observed similar curves in five patients, and at autopsy demonstrated division of the right branch of the His bundle in two if these.
Following these original contributions to the subject, bundle-branch block curves have been observed as a temporary sign during infections, congestive failure, coronary thrombosis, tachycardias and various toxic states. In most if not all of the reported cases the abnormal curves in patients with definite structural heart disease, or with extreme tachycardia. The references already cited indicate that the type of electrocardiogram under discussion may be obtained in the absence of gross division of a bundle branch.
Experimentally, bundle-branch block curves may be obtained in the normal hearts by causing an impulse to enter one bundle branch later than the other. The same result would be produced should the impulse travel through the bundle branches at different speeds or by an aberrant course. That such a mechanism may occur in the human being with normal hearts seems likely from a study of the case described in the present paper, the presumption being that vagal stimulation may, in certain individuals, give rise to aberrant ventricular complexes.
We have observed the occurrence of bundle-branch block curves in healthy young adults and children with apparently normal hearts. The curves may be typically those of complete right and left bundle-branch block, or of intermediate or lesser grades of aberration.
Wolff L, Parkinson J, White PD. Bundle-branch block with short P-R interval in healthy young people prone paroxysmal tachycardia. Am Heart J 1930; 5:685-704
Back to Top
;)
;)
;)
;)
;)
