Doerr W
Virchows Arch A Pathol Anat Histopathol. 1983;401(2):137-46. doi: 10.1007/BF00692638.
Heterochronia, heterotopia and heterometria are important elements of the pathogenic process. Heterochronia has its historical roots in the philosophy of Aristotle. As the organs of living creatures and especially man have developed, the process has been one of fitting together a variety of evolutionary bricks. Each complex organ shows evidence of a gradual control of its cellular structure. Parts of organs observed at different stages of man's development all appear to retain certain heterologous (identical) organisational features. Thus, the different pathoclisis is explained. Classical Neuropathology has made headway in this field. Its methodical procedure was adopted - mutatis mutandis - by General Pathology. The inherent structural weaknesses within the organisation of the human brain are, in their organic type of differentiation, also present in the muscular heart. The right ventricle has developed mainly from the myoepicardium of the proampulla; the left ventricle has its origin in the metaampulla. The right ventricle consists mainly of priscomyocardium, the left one of neomyocardium. This is the basis on which are founded the main characteristics of the muscular structures, the arrangement of the coronary arteries and the organisation of the conduction system. A. Keith had already discovered in 1906 that the elements of specific muscle texture contain old structures. We believe that the pacemaker cell represents the historical paradigm of the working muscle cell of the heart (the transporter). Atrioventricular collateral connections (anastomoses) are only found within the priscomyocardium, the arteria coronaria dextra being the original. The coronaria sinistra was evolved later. From the summary of facts originating from the heterochronia of heart development we can draw conclusions about the development of the major heart diseases such as: Those which are dependent on interference with the ventricle walls following oxygen deprivation and the resulting toxic stress; Those which are characterised by infarction of the myocardium which occur in areas which have a predilection for such reaction and which can be set out in a predetermined topology; Those characterised by rhythmic interferences of the heart caused by atrioventricular collateral connections; as a result of an anthropological pathomorphology.
发育异常、组织异位和发育异常量是致病过程的重要因素。发育异常有着亚里士多德哲学的历史根源。随着生物尤其是人类器官的发育,这个过程一直是将各种进化元素组合在一起的过程。每个复杂器官都显示出对其细胞结构逐渐控制的证据。在人类发育的不同阶段观察到的器官部分似乎都保留了某些异源(相同)的组织特征。因此,不同的病理选择得到了解释。经典神经病理学在这个领域取得了进展。其有条不紊的程序经适当修改后被一般病理学所采用。人类大脑组织结构中固有的结构弱点,在其器官类型的分化方面,在肌肉心脏中也存在。右心室主要由壶腹前部的心肌外层发育而来;左心室起源于壶腹中部。右心室主要由原始心肌组成,左心室由新心肌组成。这是肌肉结构的主要特征、冠状动脉的排列和传导系统的组织所基于的基础。A. 基思在1906年就已经发现特定肌肉纹理的元素包含古老结构。我们认为起搏细胞代表了心脏工作肌肉细胞(转运体)的历史范式。房室侧支连接(吻合)仅在原始心肌内发现,右冠状动脉是原始的。左冠状动脉后来进化而来。从心脏发育异常所产生的事实总结中,我们可以得出关于主要心脏病发展的结论,例如:那些依赖于缺氧后心室壁受到干扰以及由此产生的毒性应激的疾病;那些以心肌梗死为特征的疾病,这些梗死发生在对这种反应有偏好的区域,并且可以按照预定的拓扑结构列出;那些由房室侧支连接引起的心脏节律性干扰所导致的疾病;作为一种人类学病理形态学的结果。