ABSTRACT
By 1902, Sir James Mackenzie first book, The Study of the Pulse, which documented 28 years of his personal research in Burnley, had become one of the most important publications in cardiology. Importantly, Sir James’ would follow up on his patients, in some cases for over six years, enabling him to comment on their prognosis. As a result he was the first to suggest that the contemporaneous management of months of bed rest for sinus arrhythmias was unnecessary and that these patients could carry on with their lives normally. He noticed that a certain type of rhythm irregularity caused the atrial ‘a’ wave to disappear from his polygraph recording and any pre-systolic murmurs could not be heard. As a general practitioner he was a firm believer that a diagnosis should be made by observing the patient as a whole and felt that a doctor that only studied one organ was at a disadvantage.
