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Mackenzie-Lewis Polygraph (1914)

In 1906 James Mackenzie invented a twin channel ink writing polygraph and this design was modified in 1914 at University College Hospital by Thomas Lewis’s technician, Bernard A Robinson. Usually it recorded the arterial and jugular pulse, but it could also be used to record the apex beat. Its main value was in arrhythmia analysis, but the wave form of the pulses could also be usefully studied.


Image References

Mackenzie Lewis Polygraph, 1914. This apparatus in the Museum’s collection belonged to Thomas Lewis himself. He used it to simultaneously record the jugular venous and arterial pulses.


Jugular venous pulse cup, placed over the neck vein; plus a radial artery tambour, placed on the arterial pulse at the wrist. The movements of these vessels vibrate the diaphragms. These transmit the waves through rubber tubing to two recording arms which record the pulse as continuous lines on paper.


An original ink polygraph made by Thomas Lewis showing two episodes of heart block. Used in his lecture on Cardiac Syncope in Montreal on 5th October 1914. Published as Figure 73 in his monograph “Lectures on the Heart”, 1915. Time marker, JVP, radial pulse.


The Mackenzie-Lewis polygraph of 1914 has two pens, attached to tambours, which write in ink onto a roll of paper driven by clockwork. One pen is connected to a capsule (originally covered in rubber), which is strapped onto the brachial artery and records the arterial pulse. The other pen will usually record the jugular venous pulse, but can also be used to record the apex beat, or the hepatic pulse in heart failure. Those recordings are made with an open ended metal receiver. The polygraph was extensively used to diagnose and record arrhythmias even after the electrocardiogram came into regular use.


Image Reference

Mackenzie-Lewis polygraph recording showing the jugular venous pulse above, and the brachial pulse below. The venous tracing shows a dominant “A” wave in a patient with pulmonary hypertension secondary to left heart failure due to aortic insufficiency. This tracing was made in 1950 by Dr Arthur Hollman who had been a pupil of Sir Thomas Lewis at University College Hospital London in 1943.