War injuries used as research models · The triple response of the skin to injury, the H substance · Monograph on blood vessels of the human skin · Physiology and medicine · Third edition of The Mechanism · Nobel Prize for Einthoven · Death of Mackenzie · Controversy over dog experiments

Abstract

The medical Research Council’s annual reports followed the calendar of the university year by running from October, and the work in Lewis’ own department had the same pattern. From 1922 to 1923 the main topic he chose for his research emphasizes the break with electrocardiography. Together with Drury he made an intensive study of the local and general circulatory changes which occur with an arteriovenous anastomosis. The stimulus for this work came about from seeing a man who had developed such a lesion after being hit in the groin by a bullet. Whilst demonstrating to the students that pulsation in the arteriovenous aneurysm could be stopped by occluding the femoral artery he noticed that the pulse rate fell promptly and the blood pressure rose. His ‘curiosity was deeply aroused’ and this single patient led to a long series of observations both in man and dogs.¹⁹⁷ They included the finding that atropine prevented the slowing of rate when the anastomosis was closed — an excellent demonstration in man that there is a reflex response of heart rate through the vagus nerve to a rise of blood pressure, shown a few years later by Hering to be largely mediated from the carotid sinus. His patient had intense capillary pulsation and this phenomenon was also studied in cases of aortic regurgitation, a similar haemodynamic situation, when he had ‘the valuable assistance of Miss E.P. Wolf of Chicago’.¹⁶⁵ Dr Elizabeth Pauline Wolf, later Dr E.P.W. Blitzen, was the fourth woman to be one of his research workers.