Case Studies in Clinical Cardiac

Electrophysiology 1st Edition John M.

Miller
Visit to download the full and correct content document:
https://textbookfull.com/product/case-studies-in-clinical-cardiac-electrophysiology-1st-
edition-john-m-miller/
More products digital (pdf, epub, mobi) instant
download maybe you interests ...

Sex and Cardiac Electrophysiology: Differences in

Cardiac Electrical Disorders Between Men and Women 1st
Edition Marek Malik (Editor)

https://textbookfull.com/product/sex-and-cardiac-
electrophysiology-differences-in-cardiac-electrical-disorders-
between-men-and-women-1st-edition-marek-malik-editor/

Handbook of cardiac electrophysiology Second Edition

Kalyanam Shivkumar (Editor)

https://textbookfull.com/product/handbook-of-cardiac-
electrophysiology-second-edition-kalyanam-shivkumar-editor/

Handbook of Cardiac Electrophysiology 2nd Edition

Andrea Natale (Editor)

https://textbookfull.com/product/handbook-of-cardiac-
electrophysiology-2nd-edition-andrea-natale-editor/

Understanding Cardiac Electrophysiology A Conceptually

Guided Approach 1st Edition Peter Spector

https://textbookfull.com/product/understanding-cardiac-
electrophysiology-a-conceptually-guided-approach-1st-edition-
peter-spector/
The Family Nurse Practitioner: Clinical Case Studies
(Case Studies in Nursing) Leslie Neal-Boylan

https://textbookfull.com/product/the-family-nurse-practitioner-
clinical-case-studies-case-studies-in-nursing-leslie-neal-boylan/

Clinical Research Case Studies of Successes and

Failures 1st Edition John G. Brock-Utne (Auth.)

https://textbookfull.com/product/clinical-research-case-studies-
of-successes-and-failures-1st-edition-john-g-brock-utne-auth/

Case Studies in Immunology A Clinical Companion Raif

Geha

https://textbookfull.com/product/case-studies-in-immunology-a-
clinical-companion-raif-geha/

Decoding Cardiac Electrophysiology Understanding the

Techniques and Defining the Jargon Afzal Sohaib

https://textbookfull.com/product/decoding-cardiac-
electrophysiology-understanding-the-techniques-and-defining-the-
jargon-afzal-sohaib/

Voice Therapy Clinical Case Studies Joseph C. Stemple

https://textbookfull.com/product/voice-therapy-clinical-case-
studies-joseph-c-stemple/
Any screen.
Any time.
Anywhere.
Activate the eBook version
ge.
of this title at no additional charge.

Expert Consult eBooks give you the power to browse and find content,
view enhanced images, share notes and highlights—both online and offline.

Unlock your eBook today.

1 Visit expertconsult.inkling.com/redeem Scan this QR code to redeem your
eBook through your mobile device:
2 Scratch off your code
3 Type code into “Enter Code” box
4 Click “Redeem”
5 Log in or Sign up
6 Go to “My Library”
Place Peel Off
It’s that easy! Sticker Here

For technical assistance:

email expertconsult.help@elsevier.com
call 1-800-401-9962 (inside the US)
call +1-314-447-8200 (outside the US)
Use of the current edition of the electronic version of this book (eBook) is subject to the terms of the nontransferable, limited license granted on
expertconsult.inkling.com. Access to the eBook is limited to the first individual who redeems the PIN, located on the inside cover of this book,
at expertconsult.inkling.com and may not be transferred to another party by resale, lending, or other means.
2015v1.0
Case Studies in
Clinical Cardiac
Electrophysiology
 CONTENTS iii

Case Studies in
Clinical Cardiac
Electrophysiology
John M. Miller, MD
Professor of Medicine, Indiana University School of Medicine
Director, Clinical Cardiac Electrophysiology
Indianapolis, Indiana

Mithilesh K. Das, MD
Professor of Clinical Medicine, Indiana University School of Medicine
Indianapolis, Indiana

Douglas P. Zipes, MD
Distinguished Professor Emeritus of Medicine, Pharmacology and Toxicology
Indiana University School of Medicine
Emeritus Director, Krannert Institute of Cardiology
Indianapolis, Indiana
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899

CASE STUDIES IN CLINICAL CARDIAC ELECTROPHYSIOLOGY ISBN: 978-0-323-18772-5

Copyright © 2018 by Elsevier, Inc. All rights reserved.

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about the
Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance
Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.

This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).

Notices

Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds, or experiments described herein. In using such information or
methods they should be mindful of their own safety and the safety of others, including parties for whom
they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most
current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of
their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient,
and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume
any liability for any injury and/or damage to persons or property as a matter of products liability, negligence
or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the
material herein.

Library of Congress Cataloging-in-Publication Data

Names: Miller, John M. (John Michael), 1954- author. | Das, Mithilesh K.,
author. | Zipes, Douglas P., author.
Title: Case studies in clinical cardiac electrophysiology / John Miller,
Mithilesh Das, Douglas Zipes.
Description: Philadelphia, PA : Elsevier, [2018] | Includes bibliographical
references and index.
Identifiers: LCCN 2016053043 | ISBN 9780323187725 (hardcover : alk. paper)
Subjects: | MESH: Heart Diseases--diagnosis | Electrophysiologic
Techniques,
Cardiac--methods | Case Reports
Classification: LCC RC683.5.E5 | NLM WG 141.5.F9 | DDC 616.1/2075--dc23
LC record available at https://lccn.loc.gov/2016053043

Content Strategist: Maureen Iannuzzi

Senior Content Development Specialist: Janice Galliard
Publishing Services Manager: Catherine Jackson
Project Manager: Kate Mannix
Design Direction: Brian Salisbury

Printed in China

Last digit is the print number: 9 8 7 6 5 4 3 2 1

 Keenly aware of the time and energy diverted from our families that was required to
perform these procedures and assemble the recordings into a form accessible by readers, we
dedicate this volume to our beloved wives (Jeanne, Rekha, and Joan), who have allowed us
the privilege of putting this work together. We also dedicate this work to the readers, who we
hope will benefit from the lessons we have tried to convey, and finally to their patients, who
we hope will in turn benefit from their learning.
 CONTENTS

Foreword
The practice of clinical cardiac electrophysiology is one of clinical exploration that starts
with integration of the patient’s symptoms and cardiac evaluation with electrocardio-
graphic interpretation. One of the most gratifying experiences for patient and physician is
when this process culminates in the electrophysiology laboratory with confirmation of the
diagnosis and implementation of effective therapy for the arrhythmia with catheter abla-
tion. Mastery of each component is needed, and the knowledge that is gained from each
step can be applied to the previous step to refine one’s diagnostic acumen. We became
much better electrocardiographers by applying the knowledge gained from the pioneering
work that defined cardiac activation patterns and arrhythmia mechanisms using cardiac
mapping and programmed electrical stimulation. Expertise in the last step, interventional
electrophysiology, is the most challenging to acquire. It requires assimilation of complex
patterns of cardiac activation, interpretation of spontaneous changes in patterns, and ap-
plication of maneuvers to confirm a diagnosis, and this confirmation is critical for guiding
catheter ablation.
Drs. Miller, Das, and Zipes have assembled a wonderful book that captures the spirit of
clinical exploration leading to effective therapy. They use cases to describe pathophysio-
logic concepts that start with fundamentals and proceed to complex concepts. From the
electrophysiology laboratory they incorporate findings ranging from those that are classic
to those that are only recently described and that require a nuanced interpretation and
understanding, but that are critical to arriving at the correct diagnosis. Examples include
the newest technologies that are now being applied for delineation of arrhythmia mecha-
nisms and substrate.
The authors are renowned teachers who apply their wealth of experience in communi-
cating complex scenarios and concepts to make the cases accessible for the complete range
of students of clinical electrophysiology, from the trainee to the advanced practitioner.
The cases clarify concepts and provide fundamentals for the new student, but also provide
insights that will expand the knowledge of experienced clinicians. Dr Miller’s hand is
evident throughout in the superb graphics, for which he is widely known among teachers
of cardiology.
One of the amazing aspects of biology, medicine, and certainly extending to cardiac
electrophysiology, is the variability that one encounters from patient to patient. After
years in the field, one still encounters new arrhythmia problems. A solid basis in under-
standing mapping and diagnostic maneuvers is required for solving new puzzles in the
electrophysiology laboratory, and this learning is acquired from the study of cases. You
can never analyze too many cases. I congratulate the authors of Case Studies in Clinical
Cardiac Electrophysiology on a wonderful book.

William G. Stevenson, MD
Director, Cardiac Arrhythmia Program
Cardiovascular Division
Brigham and Women's Hospital
Professor of Medicine, Harvard Medical School
Boston, Massachusetts

vii
 CONTENTS

Preface
The understanding and care of patients with heart rhythm disturbances (clinical cardiac
electrophysiology [EP]) has evolved in the last three decades from simple diagnostic stud-
ies of the conduction system using a few electrodes, to complex diagnostic and therapeutic
procedures involving recording and stimulation from a large number of electrodes, for the
purpose of finding and ablating arrhythmogenic tissue. With this dramatic change in the
character of EP studies has come the critical need for careful analysis and thorough under-
standing of the meaning of recordings that are made and results of stimulation in order to
achieve optimal results from ablation. At the same time, EP training programs have come
under increasing pressure to perform more procedures in a shorter amount of time, result-
ing in compromising time for careful and methodical study of and learning from these
procedures that are rich with teaching material. Although many excellent texts in our field
explain the principles of recording and stimulation in treatment of arrhythmias, for ex-
ample, Clinical Arrhythmology and Electrophysiology, few are structured to show their
practical application in a case-study format. In light of this, the purpose of this volume is
to take the reader through a representative series of EP procedures from start to finish,
evaluating results of diagnostic pacing maneuvers, sampling and comparing characteristics
of electrograms, and selection of appropriate sites for ablation. It is our hope that readers
will benefit from this mode of presentation, highlighting some of the limitations of tech-
niques that are used on a daily basis, with the aim of improving the efficacy and safety of
procedures they perform on their patients.

Acknowledgments
We gratefully acknowledge the role played by our nursing and technical staff with whom
we performed the procedures reviewed in this work, as well as electrophysiology fellows,
whose patience in keeping catheters in place during long procedures contributed greatly to
the quality of the figures. We also acknowledge our patients, who provide a constant source
for learning.

ix
PA RT 1 Sinus Node, AV Node, and His-Purkinje System

Sinus Node and Atrioventricular

Conduction Disease 1
Case Presentation
A 56-year-old man experienced syncope while walking at work. Coworkers called emer-
gency medical services (EMS). Upon the arrival of EMS, he was awake and feeling normal
but was convinced to go to the emergency room (ER). The patient had a history of anterior
wall myocardial infarction (MI), percutaneous coronary intervention (PCI), to left anterior
descending coronary artery (LAD) several years before, and a negative stress test within the
last 6 months. Examination results were normal except for obesity. ECG showed sinus
rhythm, long PR, right bundle branch block (RBBB), left anterior fascicular block (LAFB),
and anterior scar. Echocardiogram revealed ejection fraction (EF) 40% and anterior hypo-
kinesis. The patient was referred for electrophysiology (EP) study.

Baseline ECG

I aVR V1 V4

II aVL V2 V5 Figure 1-1

III aVF V3 V6

II

The ECG in Fig. 1-1 shows sinus rhythm with a prolonged P wave (left atrial abnormality),
slightly prolonged PR interval, RBBB and left anterior fascicular block, and an extensive
anterior infarction. On the basis of this, there are many possible causes of syncope—atrial
arrhythmias (atrial flutter and fibrillation, other reentrant atrial tachycardias), heart block
(either in AV node or His-Purkinje system), or ventricular arrhythmia (ventricular tachy-
cardia or fibrillation). There is nothing in the ECG to favor one cause of syncope over
another, and because treatment strategies are very different depending on the cause
(medications or ablation for atrial arrhythmias; pacemaker for heart block; implantable
defibrillator for ventricular arrhythmias), further investigation is needed.

1
2 CASE STUDIES IN CLINICAL CARDIAC ELECTROPHYSIOLOGY

Evaluation
Baseline Intracardiac Recordings
1
2

V1

V6

HRA
Figure 1-2 A V
H
Hisprox

Hismid

Hisdist
RBB
AH 85 ms HV 85 ms
RV
200 ms

Intracardiac recordings during sinus rhythm (Fig. 1-2) show atrial (A), His (H), and
ventricular (V) recordings as noted. This confirms the presence of His-Purkinje disease,
with an HV interval of 85 ms—prolonged (normal, 40 to 55 ms), but not enough to
implicate His-Purkinje dysfunction as a cause of heart block. Surprisingly, though the PR
interval is somewhat prolonged, the AH interval is normal (85 ms [normal, 60 to 125 ms]).
Usually, prolongation of the PR interval is caused by the AV nodal (AH) component, be-
cause to prolong the PR even 60 ms from His-Purkinje disease would require a lengthening
of the HV to a degree (that is, from 40 ms to 100 ms) that 1:1 conduction would be unlikely.
Note also that there is a delay between the distal His recording and right bundle branch
(RBB)—there is usually ,10 ms between these—and that the RBBB is further caused by
delay or block between the RBB and RV apical electrogram, with a QRS onset (dashed blue
line) to RV electrogram of 75 ms (normal, 10 to 35 ms).

Sinus Rhythm And Ventricular Pacing

1
2
3
V1

V6
Figure 1-3
HRA A V V A
H
Hisprox
H
Hismid

Hisdist

RV
200 ms S S
 CHAPTER 1 | SINUS NODE AND ATRIOVENTRICULAR CONDUCTION DISEASE 3

The left side of Fig. 1-3 shows a sinus rhythm complex as in the previous figure for refer-
ence, whereas the 2 complexes on the right are during pacing from the right ventricular
apical region. Note that there is retrograde conduction to the atria, with the His bundle
activated from distal to proximal as expected. Usually, the timing of the His potential is
before the local ventricular electrogram in the His recoding, because conduction proceeds
more rapidly up the RBB to the His than does muscle-to-muscle propagation from apex to
base. Because there is RBBB in this case, the impulse cannot ascend the RBB as it normally
would and instead must traverse the interventricular septum, enter the left bundle branch,
and then activate the His retrogradely. These findings just confirm the His-Purkinje disease
but give no further insight as to the cause of syncope.

Retrograde His-Purkinje Conduction

Normal RBBB

I I
II II
V1 V1

H H
HBp HBp

HBm HBm

HBd HBd
Figure 1-4
RVA V RVA V

LBB LBB

RBB RBB

As illustrated in Fig. 1-4, in patients with normal His-Purkinje function (at left), pacing
from the right ventricular apex (red circle) results in retrograde conduction over the RBB
(white line) that is more rapid than muscle-to-muscle conduction (wavy line in septum),
resulting in a His potential (H) inscribed before the larger local ventricular recording (V).
At right, in the presence of anterograde RBBB, the paced wavefront cannot ascend the
blocked right bundle and instead crosses the interventricular septum (wavy horizontal line)
to engage the left bundle, and then proceeds rapidly to the His that now appears after the
local ventricular recording (that is again generated after muscle-to-muscle spread).
4 CASE STUDIES IN CLINICAL CARDIAC ELECTROPHYSIOLOGY

Atrial Pacing
1

V1

V6

Figure 1-5 HRA

S S S S S
AH 90 ms

Hisprox
A
HV
Hismid

Hisdist

HV 85 ms
RV 400 ms

Rapid pacing can often reveal abnormalities of AV conduction that were not very evident
at rest. In Fig. 1-5, pacing the atrium (S) slightly faster than the sinus rate shows minimal
change in either AH (90 ms) or HV (85 ms) intervals. It is useful to display multiple elec-
trode pairs of His recordings because the signal amplitude may vary enough between
complexes that the His potential may be poorly visible or even absent in one electrode pair
(Hisdist in this case), whereas it is readily visible in other electrode pairs.

Atrial Pacing

V1

V6
Figure 1-6 420 ms 400 ms 380 ms
HRA S S S S S S S S S S
AH (ms): 140 145 170 185 230 -- 115 130 190 230
Hisprox
H H H H H ∗ H H H H
Hismid
HV (ms): 100 110 112 115 115 90 115 --
Hisdist

RV
400 ms

More rapid pacing starts to reveal some abnormalities. As the pacing rate increases (cycle
length decreases), the AH is expected to prolong but the HV interval usually remains con-
stant. In Fig. 1-6, the AH (in blue) does prolong, but so does the HV interval (in green). The
asterisk denotes where AV nodal block occurs (no subsequent His potential), but three
cycles after this, there is a His potential not followed by a QRS (infra-His block; green dash)
 CHAPTER 1 | SINUS NODE AND ATRIOVENTRICULAR CONDUCTION DISEASE 5

and the HV intervals on the prior two cycles had prolonged (thus, infra-His Wenckebach).
This is distinctly abnormal and likely warrants pacemaker implantation. However, this may
not be the reason that syncope had occurred (there may be other abnormalities that have
not yet been uncovered during the study).

Atrial Pacing

V1

V6

HRA Figure 1-7

S S S 4.15 sec sinus pause

Hisprox

Hismid

Hisdist

RV
1 sec

In Fig. 1-7, pacing is repeated for 1 min at the same cycle length as shown in the
prior figure to stress the sinus node. Upon cessation of pacing, a prolonged sinus pause
(4.15 seconds) is observed; a junctional escape complex occurs after 3 seconds. This is
another potential cause of syncope (sinus node dysfunction).
6 CASE STUDIES IN CLINICAL CARDIAC ELECTROPHYSIOLOGY

Ventricular Pacing
∗
1

V1

V6
Sinus Sinus
Figure 1-8 HRA
A A A

Hisprox

Hismid
H
H H H
Hisdist

RV S S S S S S
400 ms

Turning to the ventricles (Fig. 1-8), slow ventricular pacing again shows that there is retro-
grade conduction; the first and last atrial complexes are sinus in origin (HRA before His
atrial recordings) but the middle three complexes are retrogradely conducted. The first two
of these (blue arrows) are over the fast pathway, but after the fourth ventricular stimulus,
the ventriculoatrial interval suddenly increases, signifying a switch to a slow pathway (red
arrow). Immediately after this, there is a QRS complex that is not fully paced (asterisk); this
is because of fusion between the paced wavefront and one over the normal conduction
system (see His potential). This is the result of an atypical AV nodal echo (retrograde slow
pathway, anterograde fast—blue arrow). This is a common finding and, unless accompa-
nied by sustained atypical AV nodal reentrant SVT, has no relevance for the diagnosis of
syncope.

Ventricular Stimulation

V1

V6

Figure 1-9
HRA
SA SA

Hisprox

Hismid

H H H
Hisdist

RV S
1 400 ms S1 S2 S3 S4
 CHAPTER 1 | SINUS NODE AND ATRIOVENTRICULAR CONDUCTION DISEASE 7

The last part of the syncope evaluation consists of programmed ventricular stimulation. As
shown in Fig. 1-9, standard stimulation (here, with triple extrastimuli, S2 to S4) initiates a
rapid, hemodynamically unstable ventricular tachycardia (CL 250 ms) that stopped spon-
taneously after 15 seconds. Given the presence of a prior MI and “serious” syncope, this
arrhythmia was deemed a reasonable candidate for the cause of his syncope. He received a
dual-chamber ICD later that day. Note that a His potential is seen on occasion but not with
every complex—excluding bundle branch reentry as a possible cause of the tachycardia
(SA 5 atrial stimulus).

Summary
n This man had syncope in the presence of structural heart disease—which always needs
further evaluation.
n Multiple potential causes of syncope may be present in the same patient; in this case,
n Sinus node dysfunction
n His-Purkinje dysfunction
n Ventricular tachycardia
n Judgment must be used to determine which possible cause(s) of syncope should be
treated and how.
PA RT 2 Supraventricular Arrhythmias

SECTION 1 AV Junctional Arrhythmias

Typical (“Slow-Fast”)
Atrioventricular Nodal Reentry 2
Case Presentation
A 48-year-old woman had a history of palpitations for ~5 years. Her episodes started and
stopped suddenly, lasted 1 to 2 minutes, and were associated with lightheadedness. She
came to a local emergency room with a prolonged episode: ECG showed a narrow QRS
tachycardia (by report; no ECG available) that was terminated with adenosine. She was
treated with oral diltiazem and metoprolol but continued to have supraventricular tachy-
cardia (SVT) episodes. She had a normal physical exam; non-invasive evaluation showed
no structural heart disease. She was referred for catheter ablation of her SVT.

Baseline ECGs and Intracardiac Recordings

Baseline ECG

aVR

aVL

aVF
Figure 2-1
V1

V2

V3

V4

V5

V6
1 sec

Fig. 2-1 demonstrates normal sinus rhythm without delta waves, fractionation, or prolon-
gation of the P wave or QRS and normal QT. ECG is normal.

9
10 CASE STUDIES IN CLINICAL CARDIAC ELECTROPHYSIOLOGY

Baseline Intracardiac Recording

1
2
3
V1
V6
HRA
Hisprox
A
Hisdist
H V
Figure 2-2 CSprox

CSmid

CSdist
RV
200 ms

Fig. 2-2 shows normal intracardiac intervals (AH, HV); there is no evidence of preexcita-
tion on intracardiac recordings. Normal progression of atrial activation is seen from right
atrium to His to coronary sinus proximal to distal.

Ventricular Pacing
Ventricular Pacing (600 ms)

1
2
3
V1
V6
HRA
Hisprox

Hisdist
CSprox
Figure 2-3

CSmid

CSdist
RV
S 200 ms S S

In Fig. 2-3, with ventricular pacing at 600 ms, retrograde conduction is present with a
concentric activation pattern; a retrograde His potential (arrow) is seen between stimulus
artifact and local ventricular electrogram.
 CHAPTER 2 | TYPICAL (“SLOW-FAST”) ATRIOVENTRICULAR NODAL REENTRY 11

Ventricular Pacing (470-460 ms)

1
2
3
V1
V6
HRA
Hisprox

Hisdist
CSprox
Figure 2-4

CSmid

CSdist
RV
S 200 ms S S S

With more rapid ventricular pacing (470–460 ms) the same activation sequence is seen in
Fig. 2-4, with a longer VA interval—most consistent with AV nodal conduction.

Ventricular Pacing (280 ms)

1
2
3
V1
V6
HRA
Hisprox

Hisdist
CSprox
Figure 2-5

CSmid

CSdist
RV S S S S S S S S
400 ms

In Fig. 2-5, with the sudden onset of ventricular pacing (280 ms), a His “out the back”
(arrow) is seen after second stimulus, with atrial activation dependent on His (ie, no bypass
tract). Retrograde block occurs after the third stimulus likely because of block in the
His-Purkinje system, which recovers by the fourth stimulus (after which 1:1 retrograde
conduction resumes).
12 CASE STUDIES IN CLINICAL CARDIAC ELECTROPHYSIOLOGY

ECGs Compared

ECGs Compared
SVT Sinus Rhythm

1 1

2
2
3
3
aVR aVR

aVL aVL
aVF
Figure 2-6 aVF
V1
V1

V2 V2

V3 V3

V4 V4

V5 V5

V6 V6
1 sec 1 sec

SVT was induced ((left); sinus rhythm is shown at right in Fig. 2-6. A superimposed sinus
complex (red) overlaid on SVT shows no clear difference, implying that the P wave must be
hidden within the QRS complex.

Ventricular Pacing in SVT

Ventricular Pacing

1
2
3
V1
V6
HRA
Hisprox
A
Hisdist
Figure 2-7 CSprox
V V

CSmid

CSdist
RV
S S S S S 400 ms

In Fig. 2-7, ventricular pacing during SVT conducts retrogradely to atrium with the same
activation pattern as during SVT. During SVT that resumes on cessation of pacing, atrial
activation appears concentric and within (even before) the QRS complex, excluding ortho-
dromic SVT. The long pause after pacing suggests conduction down an AV nodal slow
pathway. The “VAV” response is consistent with typical atrioventricular nodal reentry
(AVNRT), not atrial tachycardia (AT).
 CHAPTER 2 | TYPICAL (“SLOW-FAST”) ATRIOVENTRICULAR NODAL REENTRY 13

Ventricular Pacing

1
2
3
V1
V6
HRA
Hisprox

Hisdist
A
CSprox Figure 2-8
V V

CSmid

CSdist
RV
S S 200 ms

Fig. 2-8 is a faster sweep speed of Fig. 2-7, showing the same findings.

Para-Hisian Pacing

Para-Hisian Pacing

1
2
3
V1
V6 HA 90 ms

HRA
Hisprox

Hisdist S S H
CSprox Figure 2-9
SA 90 ms SA 210 ms

CSmid

CSdist
RV
200 ms

The complex at right of Fig. 2-9 shows a normal sinus complex. The complex in middle
has a wide QRS suggesting pure ventricular capture. Retrograde conduction is evident.
The complex at left is relatively narrow, indicating some element of His capture, though
not pure His capture (His 1 V capture); retrograde conduction is evident with the same
pattern as during the wider complex and S-A interval is 90 ms; in the wide complex
(V capture only), the S-A interval is 210 ms, indicating conduction only over AV node.
The retrograde His is visible (H), with HA still 90 ms.
14 CASE STUDIES IN CLINICAL CARDIAC ELECTROPHYSIOLOGY

Ventricular Extrastimuli in Sinus Rhythm

Ventricular Extrastimuli

1
2
3
V1
V6
HRA
Hisprox

Hisdist
Figure 2-10 CSprox

CSmid

CSdist
RV
S1 200 ms S1 S2

A single ventricular extrastimulus at a drive of 600 ms is shown in Fig. 2-10. A retrograde

His (blue arrow) is seen before the local ventricular electrogram on drive complexes,
whereas the His is “out the back” (red arrow) after the extrastimulus complex, as a result of
block in the right bundle branch with transseptal conduction to and then up the left bundle
to the His. If this relationship (atrial activation dependent on prior His activation) remains
constant over a range of coupling intervals, a bypass tract is excluded.

Ventricular Extrastimuli in SVT

PVC in SVT

1
2
3
V1
V6
370 ms 370 ms 350 ms 370 ms 370 ms
HRA
Hisprox

Hisdist
Figure 2-11 CSprox

CSmid

CSdist
RV
200 ms S2

In Fig. 2-11, a ventricular extrastimulus is given during SVT. The A-A interval surrounding the
extrastimulus is shorter than the rest of the A-A intervals, but the His was not refractory (blue arrow
 CHAPTER 2 | TYPICAL (“SLOW-FAST”) ATRIOVENTRICULAR NODAL REENTRY 15

shows where it would be expected if not for the extrastimulus). Advancement of the timing of
atrial activation surrounding a His-refractory ventricular extrastimulus demonstrates the existence
of a path of conduction extrinsic to the normal conduction system (bypass tract). If the extra-
stimulus occurs at a time when the His is not refractory (as here), it is feasible that conduction
could occur through the His to the AV node and atrium, and would not implicate a bypass tract.

Atrial and Ventricular Pacing and Extrastimuli During SVT

Atrial Overdrive During SVT

350 ms 370 ms
1
2
3
V1
V6
HRA S S S
Hisprox

Hisdist
CSprox Figure 2-12

PCL 350 ms

CSmid

CSdist
RV
200 ms

Overdrive atrial pacing during SVT is shown in Fig. 2-12. At first glance, the third QRS complex
appears to result from the third stimulus. On closer inspection, it is clear that the third stimulus
causes the fourth QRS complex because the V-V interval there is the same as the paced cycle
length (350 ms). This indicates the presence of slow AV nodal conduction (no surprise, because
this type of AV nodal reentry uses an anterograde slowly conducting pathway).
16 CASE STUDIES IN CLINICAL CARDIAC ELECTROPHYSIOLOGY

Atrial Extrastimuli During SVT

1
2
3
V1
V6
S2
HRA
Hisprox

Hisdist
Figure 2-13 H-H 370 ms 370 ms 370 ms 370 ms 370 ms
CSprox

CSmid

CSdist
RV 200 ms

In Fig. 2-13, a single atrial extrastimulus is given during SVT. His-His intervals are as indi-
cated; the His immediately after the extrastimulus (blue arrow) is on time and unaffected
by the stimulus. Thus, if this were a focal junctional tachycardia, it would have already
“fired” for that complex and its next occurrence should be right on time. Although this is
exactly what happens—the next His (red arrow) occurs on time—this finding is also con-
sistent with AV nodal reentry or even AT conducting over a slow AV nodal pathway (the
impulse is already on its way down the slow pathway and is unaffected by the atrial extra-
stimulus). Thus this finding by itself is not diagnostic of focal junctional tachycardia.

Atrial Extrastimuli During SVT

1
2
3
V1
V6 S2 S3
HRA
Hisprox
Hisdist H-H 370 ms 370 ms 370 ms 350 ms 370 ms
Figure 2-14 CSprox

CSmid

CSdist
RV 200 ms

Double atrial extrastimuli are now given during SVT (Fig. 2-14). The His potential after second
extrastimulus (blue arrow) is on time (370 ms), unaffected by the first atrial stimulus (S2). How-
ever, the next His (red arrow), driven by the second atrial stimulus (S3) is advanced by 20 ms. This
shows that focal junctional tachycardia cannot be the diagnosis, because a focal discharge from
the His at the red arrow cannot be advanced by an atrial stimulus that did not affect the prior His.
 CHAPTER 2 | TYPICAL (“SLOW-FAST”) ATRIOVENTRICULAR NODAL REENTRY 17

Atrial Overdrive During SVT

1
2
3
V1
V6
HRA S S S
Hisprox

Hisdist
CSprox Figure 2-15
AH 362 ms AH 330 ms

CSmid

CSdist
RV
200 ms

Atrial overdrive pacing during SVT is performed again, as shown in Fig. 2-15; the AH in-
terval with pacing (362 ms) exceeds the AH in SVT (330 ms); this is consistent with AV
nodal reentry and inconsistent with right AT (in which case the AH intervals should be
similar between pacing and SVT).

Ventricular Pacing vs SVT

1
2
3
V1
V6
HRA
Hisprox

Hisdist
CSprox HA 92 ms HA 80 ms
Figure 2-16

CSmid

CSdist
RV
S 200 ms S

The HA interval with ventricular pacing at the SVT cycle length (92 ms) is always the same
as or longer than HA in SVT (80 ms), when measured as shown in Fig. 2-16 (end of His to
A during pacing, onset of His to A during SVT, with standard 5-mm interelectrode record-
ing catheters). This is not found with very closely spaced, very proximal His recordings,
however, where the difference between HA intervals with pacing and SVT narrows as the
point of turnaround between anterograde slow and retrograde fast pathways occurs.
18 CASE STUDIES IN CLINICAL CARDIAC ELECTROPHYSIOLOGY

Ventricular Overdrive During SVT

1
2
3
V1

V6
HRA
Hisprox

Hisdist
Figure 2-17 CSprox

CSmid

SA 166 ms VA 46 ms
CSdist
RV PPI 544 ms
S PCL 320 ms S 200 ms TCL 344 ms

Ventricular overdrive pacing during SVT is shown in Fig. 2-17, with intervals as indicated;
the SA-VA difference (120 ms) exceeds 85 ms, and the postpacing interval (PPI)–tachycardia
cycle length (TCL) difference (200 ms) exceeds 115 ms; both indices indicate AV nodal
reentry rather than orthodromic SVT.

Cartoons and Ladder Diagrams of Pacing

Orthodromic reentry
SVT

Atrium

AV node

Ventricle

Entrained ventricular pacing

Figure 2-18 SAVpacing VASVT

Atrium

AV node

Ventricle

PPI TCL
SAVpacing - VASVT > 85 ms

PPI - TCL > 115 ms

Fig. 2-18 displays entrained ventricular pacing during orthodromic SVT; the bypass tract
shown here (connecting left atrium and left ventricle) is indicated in the ladder diagrams
as a dotted line.
Another random document with
no related content on Scribd:
The Project Gutenberg eBook of Colonial days in
old New York
 This ebook is for the use of anyone anywhere in the United
States and most other parts of the world at no cost and with
almost no restrictions whatsoever. You may copy it, give it away
or re-use it under the terms of the Project Gutenberg License
included with this ebook or online at www.gutenberg.org. If you
are not located in the United States, you will have to check the
laws of the country where you are located before using this
eBook.

Title: Colonial days in old New York

Author: Alice Morse Earle

Release date: December 5, 2023 [eBook #72327]

Language: English

Original publication: New York: Charles Scribner's Sons, 1896

Credits: The Online Distributed Proofreading Team at

https://www.pgdp.net (This file was produced from
images generously made available by The Internet
Archive)

*** START OF THE PROJECT GUTENBERG EBOOK COLONIAL

DAYS IN OLD NEW YORK ***
COLONIAL DAYS
IN
OLD NEW YORK
BY
ALICE MORSE EARLE

NEW YORK
CHARLES SCRIBNER’S SONS
1896
 Copyright, 1896,
By Charles Scribner’s Sons.

University Press:
John Wilson and Son, Cambridge, U.S.A.
 TO
THE SOCIETY OF COLONIAL DAMES
OF THE
STATE OF NEW YORK
THIS BOOK IS DEDICATED BY A LOYAL
AND LOVING MEMBER
THE AUTHOR
 PREFACE
This book should perhaps have been “intituled” Colonial Days in
New Netherland, for much of the life described herein was in the
days of Dutch rule. But it was New Netherland for scarce half a
century, and the name is half-forgotten, though it remained, both in
outer life and in heart, a Dutch colonie, even when the province was
New York and an English governor had control. In New Netherland,
as in every place where the Dutch plant a colony, as in South Africa
to-day, Dutch ways, Dutch notions, the Dutch tongue lingered long.
To this day, Dutch influence and Dutch traits, as well as Dutch
names, are ever present and are a force in New York life.
Fair and beautiful lay the broad harbor centuries ago before the
eyes of Hendrick Hudson and his sea-weary men; a “pleasant place”
was Manhattan; “’t lange eylandt was the pearel of New Nederland;”
the noble river, the fertile shores, all seemed to the discoverers and
to the early colonists to smile a welcome and a promise of happy
homes. Still to-day the bay, the islands, the river, the shores
welcome with the same promise. In grateful thanks for that welcome
and for the fulfilment of that promise of old,—for more years of life in
New York than were spent in my birth-place in New England,—and
in warm affection for my many friends of Dutch descent, have I—to
use the words of Rabelais—“adjoined these words and testimony for
the honour I bear to antiquity.”
ALICE MORSE EARLE.
Brooklyn Heights,
September, 1896.
 CONTENTS
Chapter Page
I. The Life of a Day 1
II. Education and Child-Life 14
III. Wooing and Wedding 45
IV. Town Life 70
V. Dutch Town Homes 98
VI. Dutch Farmhouses 115
VII. The Dutch Larder 128
VIII. The Dutch Vrouws 154
IX. The Colonial Wardrobe 172
X. Holidays 185
XI. Amusements and Sports 204
XII. Crimes and Punishments 227
XIII. Church and Sunday in Old New York 261
XIV. “The End of his Days” 293
COLONIAL DAYS
IN

OLD NEW YORK

 CHAPTER I
THE LIFE OF A DAY

At the first break of day, every spring and summer morn, the quiet
Dutch sleepers in the old colonial town of Albany were roused by
three loud blasts of a horn sounded far and wide by a sturdy cow-
herd; and from street and dooryard came in quick answer the jingle-
jangle, the klingle-klangle of scores of loud-tongued brass and iron
bells which hung from the necks of steady-going hungry Dutch cows
who followed the town-herder forth each day to pastures green.
On the broad town-commons or the fertile river-meadows Uldrick
Heyn and his “chosen proper youngster,” his legally appointed aid,
watched faithfully all day long their neighbors’ cattle; and as honest
herdsmen earned well their sea-want and their handsel of butter,
dallying not in tavern, and drinking not of wine, as they were sternly
forbidden by the schepens, until when early dews were falling they
quit their meadow grasses mellow, for “at a quarter of an hour before
the sun goes down the cattle shall be delivered at the church.”
Thence the patient kine slowly wandered or were driven each to her
own home-stall, her protecting cow-shed.
In New Amsterdam the town’s cow-herd was Gabriel Carpsey; and
when his day’s work was done, he walked at sunset through the
narrow lanes and streets of the little settlement, sounding at each
dooryard Gabriel’s horn, a warning note of safe return and milking-
time.
Until mid-November did the morning cow-horn waken the burghers
and their vrouws at sunrise; and when with cold winter the horn lay
silent, they must have sorely missed their unfailing eye-opener.
Scarce had the last cow departed in the early morn from her
master’s dooryard, before there rose in the gray light from each vast-
throated chimney throughout the little town a faint line of pale,
wavering smoke blown up in increasing puffs with skilful bellows
from last night’s brands upon the hearth. And quickly the slender line
of smoke grew and grew to a great cloud over each steep-roofed
house, and soon with the smell of the burning brush and light pine
that were coaxing into hot flames the sturdy oak back and fore logs,
were borne forth also appetizing odors of breakfast to greet the early
morn, telling of each thrifty huys-vrouw who within the walls of her
cheerful kitchen was cooking a good solid Dutch breakfast for her
mann.
Cans of buttermilk or good beer, brewed perhaps by the patroon,
washed down this breakfast of suppawn and rye-bread and grated
cheese and sausage or head-cheese; beer there was in plenty, in
ankers, even in tuns, in every household. Soon mynheer filled his
long pipe with native tobacco, and departed with much deliberation
of movement; a sturdy, honest figure, of decent carriage, neatly and
soberly and warmly clad, with thrift and prosperity and contentment
showing in every curve of his too-well-rounded figure. Adown the
narrow street he paused to trade in peltries or lumber, if he were
middle-aged and well-to-do; and were he sturdy and young, he
threshed grain on the barn-floor, or ground corn at the windmill, or
felled wood on the hillside; or perchance, were he old or young, he
fished in the river all day long,—a truly dignified day’s work, meet for
any sober citizen, one requiring much judgment and skill and
reflection.
And as he fished, again he smoked, and ever he smoked. “The
Dutch are obstinate and incessant smokers,” chronicles the English
clergyman Wolley, Chaplain of Fort James, New York, in 1678,
“whose diet, especially of the boorish sort, being sallets and brawn
and very often picked buttermilk, require the use of that herb to keep
their phlegm from coagulating and curdling.” The word “boorish” was
not a term of reproach, nor was the frequent appellation “Dutch
bore,” over which some historians of the colony have seen fit to
make merry, both boor and bore meaning simply boer, or farmer.
“Knave meant once no more than lad; villain than peasant; a boor
was only a farmer; a varlet was but a serving-man; a churl but a
strong fellow.”
 What fishing was to the goodman of the house, knitting was to the
goodwife,—a soothing, monotonous occupation, ever at hand, ever
welcome, ever useful. Why, the family could scarce be clothed in
comfort without these clicking needles! A goodly supply of well-knit,
carefully dyed stockings was the housekeeper’s pride; and well they
might be, for little were they hidden. The full knee-breeches of father
and son displayed above the buckled shoes a long expanse of
sturdy hosiery, and the short petticoats of mother and daughter did
not hide the scarlet clocks of their own making. From the moment
when the farmer gave the fleece of the sheep into the hands of his
women-kind, every step of its transformation into stockings (except
the knitting) was so tiresome and tedious that it is wearying even to
read of it,—cleaning, washing, dyeing, carding, greasing, rolling,
spinning, winding, rinsing, knotting,—truly might the light, tidy, easy
knitting seem a pastime.
The endless round of “domesticall kind of drudgeries that women
are put to,” as Howell says, would prove a very full list when made
out from the life of one of these colonial housewives. It seems to us,
of modern labor-saved and drudgery-void days, a truly overwhelming
list; but the Dutch huys-vrouw did not stagger under the burden, nor
shrink from it, nor, indeed, did she deem any of her daily work
drudgery. The sense of thrift, of plenty, of capability, of satisfaction,
was so strong as to overcome the distaste to the labor of production.
She had as a recreation, a delight, the care of

“A garden through whose latticed gates

The imprisoned pinks and tulips gazed,”

a trim, stiff little garden, which often graced the narrow front
dooryard; a garden perhaps of a single flower-bed surrounded by
aromatic herbs for medicinal and culinary use, but homelike and
beloved as such gardens ever are, and specially beloved as such
gardens are by the Dutch. Many were the tulip bulbs and
“coronation” pink roots that had been brought or sent over from
Holland, and were affectionately cherished as reminders of the far-
away Fatherland. The enthusiastic traveller Van der Donck wrote
that by 1653 Netherlanders had already blooming in their American
garden-borders “white and red roses, stock roses, cornelian roses,
eglantine, jenoffelins, gillyflowers, different varieties of fine tulips,
crown-imperials, white lilies, anemones, bare-dames, violets,
marigolds, summer-sots, clove-trees.” Garden-flowers of native
growth were “sunflowers, red and yellow lilies, morning-stars, bell-
flowers, red and white and yellow maritoffles.” I do not know what all
these “flower-gentles” were, but surely it was no dull array of
blossoms; nor were their glories dimmed because they opened ever
by the side of the homely cabbages and lettuce, the humble
cucumbers and beans, that were equally beloved and tended by the
garden-maker.
And the housewife had her beloved and homelike poultry. Flocks
of snowy geese went waddling slowly down the town streets,
seeking the water-side; giving rich promise of fat holiday dinners and
plumper and more plentiful feather-beds; comfortable and thriving
looking as geese always are, and ever indicative of prosperous,
thrifty homes, they comported well with the pipe-smoking burgher
and his knitting huys-vrouw and their homelike dwelling.
There was one element of beauty and picturesqueness which
idealized the little town and gave it an added element of life,—

“Over all and everywhere

The sails of windmills sink and soar
Like wings of sea-gulls on the shore.”

The beauty of the windmills probably was not so endearing to the

settlers as their homelikeness. They made the new strange land and
the new little towns seem like the Fatherland. The Indians greatly
feared them; as one chronicler states, “they durst not come near
their long arms and big teeth biting the corn in pieces.” Last, and not
least in the minds of the thrifty Dutch, the windmills helped to turn to
profit the rich harvests of grain which were the true foundation of the
colony’s prosperity,—not the rich peltries of beaver, as was at first
boastfully vaunted by the fur-traders.
As the day wore on, the day’s work was ended, and a neighborly
consultation and exchange of greetings formed the day’s recreation.
The burgher went to the little market-house, and with his neighbors
and a few chance travellers, such as the skippers on the river-
sloops, he smoked again his long pipe and talked over the weighty
affairs of the colonie. In the summer-time goodman and goodwife
both went from stoop to stoop of the close-gathered houses, for a
klappernye, or chat all together. This was a feature of the colony,
architectural and social, and noted by all travellers,—“the benches at
the door, on which the old carls sit and smoke.” Here the goodwife
recounted the simple events of the day,—the number of skeins of
yarn she had spun; the yards of linen she had woven; the doings of
the dye-pot; the crankiness of the churning, to which she had sung
her churning charm,—

“Buitterchee, buitterchee, comm

Alican laidlechee tubichee vall.”

Perhaps she told her commeres, her gossips, of a fresh suspicion

of a betrothal, or perhaps sad news of a sick neighbor or a funeral.
This was never scandal, for each one’s affairs were every one’s
affairs; in the weal or woe of one the whole community joined, and in
many of the influences or effects of that weal or woe all had a part. It
was noted by historians that the Dutch were most open in discussion
of all the doings of the community, and had no dread of publicity of
every-day life.
Of this habit of colonial neighborliness, Mrs. Anne Grant wrote in
her “Memoir of an American Lady”—Madam Schuyler—from
contemporary knowledge of early life in Albany:—
“The life of new settlers in a situation like this, when the
very foundations of society were to be laid, was a life of
exigencies. Every individual took an interest in the general
 welfare, and contributed their respective shares of intelligence
and sagacity to aid plans that embraced important objects
relative to the common good. This community seemed to
have a common stock, not only of sufferings and enjoyments,
but of information and ideas.”
When the sun was setting and the cows came home, the family
gathered on stools and forms around the well-supplied board, and a
plentiful supper of suppawn and milk and a sallet filled the hungry
mouths, and was eaten from wooden trenchers and pewter
porringers with pewter or silver spoons. The night had come; here
were shelter and a warm hearthstone, and, though in the new wild
world, it was in truth a home.
Sometimes, silently smoking with the man of the house, there sat
in the winter schemer-licht, the shadow-light or gloaming, around the
great glowing hearth, a group of dusky picturesque forms,—friendly
Mohawks, who, when their furs were safely sold, could be
welcomed, and were ever tolerated and harbored by the kindly
Swannekins; and as the shadows gathered into the “fore-night,” and
the fierce wind screamed down the great chimney and drew out into
the darkness long tongues of orange and scarlet flames from the oak
and hickory fires (burning, says one early traveller, half up the
chimney), there was homely comfort within, and peace in the white
man’s wigwam.

“What matter how the North-wind raved,—

Blow high, blow low, not all its snow
Could quench that hearth-fire’s ruddy glow.”

And the blanketed squaw felt in her savage breast the spirit of that
home, and gently nursed her swaddled pappoose; and the silent
Wilden, ever smoking, listened to the Dutch huys-moeder, who,
undressing little Hybertje and Jan and Goosje for their long night’s
sleep, sang to them the nursery song of the Hollanders, of the
Fatherland:—
 “Trip a troup a tronjes,
De vaarken in de boonjes,
De koejes in de klaver,
De paarden in de haver,
De kalver in de lang gras,
De eenjes in de water plas,
So groot myn klein poppetje was.”

Or if it were mid-December, the children sang to Kriss-Kringle:—

“Saint Nicholaes, goed heilig man,

Trekt uw’ besten tabbard aan,
En reist daamee naar Amsterdam,
Von Amsterdam naar Spange,
Waar Appellen von Orange
En Appellen von Granaten
Rollen door de straaten.

“Saint Nicholaes, myn goeden vriend,

Ik heb uwe altyd wel gediend,
Als gy my nu wat wilt geben
Zal ik un dienen als myn leben.”

Then the warming-pan was filled with hot coals, and thrust warily
between the ice-cold sheets of the children’s beds, and perhaps they
were given a drink of mulled cider or simmering beer; and scarcely
were they sleeping in their warm flannel cosyntjes, or night-caps with
long capes, when the curfew rang out from the church belfry. It was
eight o’clock,—’t Is tijdt te bedde te gaen. The housewife carefully
covered “the dull red brands with ashes over” for the fire of the
morrow, and went to bed. The “tap-toes” sounded from the fort, and
every house was silent.
And as the honest mynheer and his good vrouw slept warmly in
their fireside alcove, and softly between their great feather-beds, so
they also slept serenely; for they were not left unprotected from
marauding Indian or Christian, nor unwatched by the ever-thoughtful
town authorities. Through the little town marched boldly every night a
sturdy kloppermann, or rattle-watch, with strong staff and brass-
bound hourglass and lighted lanthorn; and, best of all, he bore a
large klopper, or rattle, which he shook loudly and reassuringly at
each door all through the dark hours of the night, “from nine o’clock
to break of the day,” to warn both housekeepers and thieves that he
was near at hand; and as was bidden by the worshipful schepens,
he called out what o’clock, and what weather;—and thus guarded, let
us leave them sleeping, these honest Dutch home-folk, as they have
now slept for centuries in death, waiting to hear called out to them
with clear voice “at break of the day” from another world, “A fair
morning, and all’s well.”
 CHAPTER II
EDUCATION AND CHILD-LIFE

As soon as the little American baby was born in New Netherland,

he was taken to the church by his Dutch papa, and with due array of
sponsors was christened by the domine from the doop-becken, or
dipping-bowl, in the Dutch Reformed Church. New Yorkers had a
beautiful silver doop-becken in 1695, and the church on the corner of
Thirty-Eighth Street and Madison Avenue has it still. It was made in
Amsterdam from silver coin and ornaments brought by the good folk
of the Garden Street Church as offerings. For it Domine Henricus
Selyns, “of nimble faculty,” then minister of that church, and formerly
of Breuckelen, and the first poet of Brooklyn, wrote these pious and
graceful verses, which were inscribed on the bowl:

“Op’t blote water stelt geen hoot

’Twas beter noyt gebooren.
Maer, ziet iets meerder in de Dorp
Zo’ gaet nien noÿt verlooren.
Hoe Christús met sÿn dierbaer Bloedt
Mÿ reÿniglt van myn Zonden.
En door syn Geest mÿ leven doet
En wast mÿn Vuÿle Wonden.”

Which translated reads:—

“Do not put your hope in simple water alone, ’twere better
never to be born.
But behold something more in baptism, for that will prevent
your getting lost.
How Christ’s precious blood cleanses me of my sins,
 And now I may live through His spirit and be cleansed of my
vile wounds.”

This christening was the sole social or marked event of the

kindeken’s infancy, and little else do we know of his early life. He ate
and slept, as do all infants. In cradles slept these children of the
Dutch,—deep-hooded cradles to protect from the chill draughts of
the poorly heated houses. In cradles of birch bark the Albany babies
slept; and pretty it was to see the fat little Dutch-men sleeping in
those wildwood tributes of the Indian mothers’ skill to the children of
the men who had driven the children of the redmen from their
homes.
Children were respectful, almost cowed, in their bearing to their
parents, and were enjoined by ministers and magistrates to filial
obedience. When the government left the Dutch control and became
English, the Calvinistic sternness of laws as to obedience to parents
in maturer years which was seen in New England was also found in
New York.
“If any Child or Children, above sixteen years of age, and of
Sufficient understanding, shall smite their Natural Father or
Mother, unless provoked and forct for their selfe preservation
from Death or Mayming, at the Complaint of the said Father
or Mother, and not otherwise, they being Sufficient witness
thereof, that Child, or those Children so offending shall be put
to Death.”
A few prim little letters of English children have survived the wear
and tear of years, and still show us in their pretty wording the formal
and respectful language of the times. Martha Bockée Flint, in that
interesting and valuable book, “Early Long Island,” gives this letter
written to Major Ephenetus Platt “at Huntting-town” by a little girl
eleven years old:—
Ever Honored Grandfather;
Sir: My long absence from you and my dear Grandmother
has been not a little tedious to me. But what renders me a