Sir James Mackenzie
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Sir James Mackenzie (12 April 1853 – 26 January 1925) was a Scottish
cardiologist Cardiology () is a branch of medicine that deals with disorders of the heart and the cardiovascular system. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular ...
who was a pioneer in the study of
cardiac arrhythmia Arrhythmias, also known as cardiac arrhythmias, heart arrhythmias, or dysrhythmias, are irregularities in the heartbeat, including when it is too fast or too slow. A resting heart rate that is too fast – above 100 beats per minute in adults ...
s. Due to his work in the cardiac field he is known as a research giant in primary care, and was knighted by King
George V George V (George Frederick Ernest Albert; 3 June 1865 – 20 January 1936) was King of the United Kingdom and the British Dominions, and Emperor of India, from 6 May 1910 until his death in 1936. Born during the reign of his grandmother Qu ...
in
1915 Events Below, the events of World War I have the "WWI" prefix. January * January – British physicist Sir Joseph Larmor publishes his observations on "The Influence of Local Atmospheric Cooling on Astronomical Refraction". * January ...
.


Biography

James Mackenzie was born at Pictonhill in
Scone A scone is a baked good, usually made of either wheat or oatmeal with baking powder as a leavening agent, and baked on sheet pans. A scone is often slightly sweetened and occasionally glazed with egg wash. The scone is a basic component ...
, where his father was a farmer. He left school at Perth Academy aged 14 and was apprenticed to a chemist. In 1873 he was offered a partnership in the chemist's firm but turned it down in order to study medicine. After private tuition in Latin he passed his entrance examination for the
University of Edinburgh The University of Edinburgh ( sco, University o Edinburgh, gd, Oilthigh Dhùn Èideann; abbreviated as ''Edin.'' in post-nominals) is a public research university based in Edinburgh, Scotland. Granted a royal charter by King James VI in 15 ...
in October 1874 and qualified as a doctor in 1878. After completing his residency in Edinburgh, Mackenzie became a general practitioner in
borough of Burnley The Borough of Burnley () is a local government district with the borough status in Lancashire, England. It has an area of and a population of (), and is named after its largest town, Burnley. Other notable settlements include Padiham, Ha ...
in
Lancashire Lancashire ( , ; abbreviated Lancs) is the name of a historic county, ceremonial county, and non-metropolitan county in North West England. The boundaries of these three areas differ significantly. The non-metropolitan county of Lancash ...
,
England England is a country that is part of the United Kingdom. It shares land borders with Wales to its west and Scotland to its north. The Irish Sea lies northwest and the Celtic Sea to the southwest. It is separated from continental Europe b ...
where he continued to practice medicine for more than a quarter of a century. While he was engaged in a busy practice, he made many original observations, completed his MD degree on hemi-paraplegia spinalis (awarded by the
University of Edinburgh The University of Edinburgh ( sco, University o Edinburgh, gd, Oilthigh Dhùn Èideann; abbreviated as ''Edin.'' in post-nominals) is a public research university based in Edinburgh, Scotland. Granted a royal charter by King James VI in 15 ...
in 1882) and had many scientific papers published. During Mackenzie's initial research carried out in the Burnley general practice he corresponded and discussed his findings with other well known pioneers Wenkebach and Osler. Mackenzie's ongoing investigations led him to leave general practice and become a specialist cardiologist. He expressed prophetic concerns about the specialisation of medicine including cardiology stating: 'I fear the day may come when a heart specialist will no longer be a physician looking at the body as a whole, but one with more and more complicated instruments working in a narrow and restricted area of the body – that was never my idea'. In his early studies Mackenzie used Riva-Rocci's
sphygmograph The sphygmograph ( ) was a mechanical device used to measure blood pressure in the mid-19th century. It was developed in 1854 by German physiologist Karl von Vierordt (1818–1884). It is considered the first external, non-intrusive device used ...
to graphically record the
pulse In medicine, a pulse represents the tactile arterial palpation of the cardiac cycle (heartbeat) by trained fingertips. The pulse may be palpated in any place that allows an artery to be compressed near the surface of the body, such as at the n ...
. Later Mackenzie devised a "
polygraph A polygraph, often incorrectly referred to as a lie detector test, is a device or procedure that measures and records several physiological indicators such as blood pressure, pulse, respiration, and skin conductivity while a person is asked ...
," that allowed him to make simultaneous records of the arterial and venous pulses. He used this to evaluate the condition of the
heart The heart is a muscular organ in most animals. This organ pumps blood through the blood vessels of the circulatory system. The pumped blood carries oxygen and nutrients to the body, while carrying metabolic waste such as carbon dioxide to t ...
and to measure the AV interval. In 1890 he discovered premature ventricular contractions and use of the polygraph enabled Mackenzie to make original distinctions between harmless and dangerous types of pulse irregularities (arrhythmias). Mackenzie also demonstrated the efficacy of
Digitalis ''Digitalis'' ( or ) is a genus of about 20 species of herbaceous perennial plants, shrubs, and biennials, commonly called foxgloves. ''Digitalis'' is native to Europe, western Asia, and northwestern Africa. The flowers are tubular in shap ...
in the treatment of arrhythmias and made important contributions to the study of the energetics of the heart muscle. In November 1907 Mackenzie left Burnley for
London London is the capital and List of urban areas in the United Kingdom, largest city of England and the United Kingdom, with a population of just under 9 million. It stands on the River Thames in south-east England at the head of a estuary dow ...
and set up as a consulting physician where his reputation grew rapidly. In 1915 he was elected a
Fellow of the Royal Society Fellowship of the Royal Society (FRS, ForMemRS and HonFRS) is an award granted by the judges of the Royal Society of London to individuals who have made a "substantial contribution to the improvement of natural knowledge, including mathemat ...
and was
knight A knight is a person granted an honorary title of knighthood by a head of state (including the Pope) or representative for service to the monarch, the church or the country, especially in a military capacity. Knighthood finds origins in the Gr ...
ed. Three years later he founded the influential Mackenzie Institute of Clinical Research in St Andrews, which involved local General Practitioners in detailed long-term recording of patients' symptoms and illnesses. Ironically Mackenzie himself suffered from an irregular heart beat, as a result of ischemic heart disease. He had his first heart attack in 1901, and recorded in himself the atrial fibrillation that accompanied this episode. By 1907 Mackenzie experienced frequent episodes of
angina pectoris Angina, also known as angina pectoris, is chest pain or pressure, usually caused by insufficient blood flow to the heart muscle (myocardium). It is most commonly a symptom of coronary artery disease. Angina is typically the result of obstru ...
which he mentioned to
Sir Thomas Lewis Sir Thomas Lewis, CBE, FRS, FRCP (26 December 1881 – 17 March 1945) was a British cardiologist (although he personally disliked the term, preferring cardiovascular disease specialist). He coined the term " clinical science".Biography, ''Oxf ...
and in 1908 he had a severe episode of cardiac pain, probably due to a myocardial infarction. His angina continued after 1908 and became progressively worse until in January 1925 he had a prolonged and severe attack of angina and died at around 4am on 26 January 1925. Before his death Mackenzie had asked that his friend John Parkinson perform an autopsy after his death. This was done and showed extensive coronary artery disease and evidence of recent and old
myocardial infarction A myocardial infarction (MI), commonly known as a heart attack, occurs when blood flow decreases or stops to the coronary artery of the heart, causing damage to the heart muscle. The most common symptom is chest pain or discomfort which may ...
. A description of the case was published in the ''British Heart Journal'' in 1939. Two early polygraphs and a bronze bust of Mackenzie are in the collection of the Tayside Medical History Museum.


Selected writings

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References


Other sources

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External links


A Biography of James Mackenzie


* [https://medicine.st-andrews.ac.uk/mackenzie/ The Sir James Mackenzie Institute for Early Diagnosis is established at the University of St. Andrews in 2019 in recognition of Sir James' research in the field of early diagnosis] {{DEFAULTSORT:Mackenzie, James 1853 births 1925 deaths People from Perth and Kinross British cardiologists Alumni of the University of Edinburgh Knights Bachelor Fellows of the Royal Society Fellows of the Royal College of Physicians 19th-century Scottish medical doctors 20th-century Scottish medical doctors