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Willem Einthoven

Born  1860
Died  1927

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Dutch physiologist, born May 21, 1860, Samarang, Java, Dutch East India, now Indonesia; died September 28, 1927, Leiden, the Netherlands.

Biography of Willem Einthoven

Willem Einthoven was the eldest son, and the third child oft six born to Jacob Einthoven, an army medical officer in the Indies who was born and educated in Groningen, The Netherlands, and later became parish doctor in Semarang. His mother was Louise M. M. C. de Vogel, daughter of the then Director of Finance in the Indies. Willem

A young man goes to school
Einthoven lost his father when he was ten years old, in 1870, and his mother settled in Utrecht with their six children. There Willem Einthoven graduated from secondary school – "Hogere Burgerschool" – and registered as a medical student at the University of Utrecht in 1878.

As a student he was particularly influenced by the physicist Christophorus Henricus Didericus Buys-Ballot (1817-1890), then the anatomist Willem Koster (1834-1907) and the ophthalmologist Herman Snellen (1834-1908), and finally Franz Cornelis Donders (1818-1889). He worked as an assistant to Snellen in the renowned eye-hospital Gasthuis voor Ooglidders. Under the direction of Koster he wrote Quelques remarques sur le mécanisme de l'articulation du coude (Some remarks on the elbow joint). He obtained his medical doctorate on July 4, 1885, with the dissertation Stereoscopie door kleurverschil (Stereoscopy by means of colour variation), an investigation made under the guidance of Donders. In December that year he was appointed professor of physiology at Leiden, succeeding Adriaan Heynsius (1831-1885). His inaugural address was entitled De leer der specifieke energieen (The theory of specific energies). In January 1886 he qualified as a general practitioner, and later that year he married his cousin Frédérique Jeanne Louise de Vogel; they had three daughters and a son.

The electric experience
In 1887, the London physiologist Augustus Desiré Waller (1856-1922) at St. Mary's Medical School, using a capillary electrometer, first succeeded in registering the current of the heart as deduced from the body surface. However, he had announced that he was unable to calculate its true shape as recorded with the capillary electrometer invented by the French physicist Gabriel Lippmann (1845–1921) in 1873.

Étienne-Jules Marey (1830-1904) in 1876 had recorded the first electrocardiogram using the mercury capillary electrometer, but Waller was the first to record the electrocardiogram of a human heart. Waller conducted his experiments on his bulldog Jimmie.

In 1889 Einthoven saw Waller demonstrate his technique at the First International Congress of Physiologists.

Einthoven repeated this experiment and, in 1895, while working on the construction of this instrument and developing the necessary photographic equipment, with the capillary electrometer he registered graphic reproductions of the variations of the electric charges induced by the contractions of the heart’s musculature, as well as heart sounds of humans and animals. Einthoven defined the physical constants of the capillary electrometer and calculated the true curve, which he called the electrocardiogram.

On a string
In 1901, Einthoven invented a new galvanometer for producing electrocardiograms using a fine quartz string coated in silver based on ideas by Deprez and d'Arsonval, who used a wire coil. His "string galvanometer" weighs 600 pounds. Einthoven acknowledged the similar system by Clément Ader (1841-1926), but later, in 1909, calculated that his galvanometer was in fact many thousands of times more sensitive.

"The string galvanometer is essentially composed of a thin silver-coated quartz filament (about 3 microns thick): which is stretched like a string, in a strong magnetic field. When an electric current is conducted through this quartz filament the filament reveals a movement which can be observed and photographed by means of considerable magnification; this movement is similar to the movements of the mercury contained in the capillary-electrometer. It is possible to regulate the sensitivity of the galvanometer very accurately within broad limits by tightening or loosening the string."

This was an improvement over the capillary galvanometer, and the original galvanometer invented by Johann Salomo Christoph Schweigger (1779-1857) in Halle in 1820. Einthoven published the first electrocardiogram recorded on a string galvanometer in 1902.

In 1905, Einthoven began transmitting electrocardiograms from the hospital to his laboratory 1.5 km away via telephone cable. On March 22nd that year the first telecardiogram was recorded from a healthy and vigorous man and the tall R waves were attributed to his cycling from laboratory to hospital for the recording.

Later research
In 1912 Einthoven’s research on the explanation of the respiratory changes in the electrocardiogram led him to the scheme of the equilateral triangle, considering the extremities as elongations of the electrodes. The information received from the contacts thus represents the projection of what takes place in the heart. With simultaneous registration of the three contacts, the size and direction of the resultant of all potential differences in the heart could be calculated minute by minute. Clinical electrocardiograms were studied by connecting patients with heart disease in the academic hospital to the instrument in Einthoven’s laboratory by means of a cable.

His last major physical experiment, which he carried out in company with his son, was concerned with the reception of the radio telegrams broadcast by the machine transmitter «Malabar» in Java. In this case the string of 0,1 micron diameter and six millimetres length had to be synchronized with the 40.000 vibrations of transmitting wave. Einthoven and his son found the resonance point after they achieved a variation in tension of one micromicron, after which telegrams from the machine transmitter, working at top speed, were perfectly photographed on paper one centimetre wide.

Einthoven’s last work was his treatise on the action current of the heart, which appeared posthumously in Albrecht Bethe’s 1872-Handbuch der normalen und pathologischen Anatomie, Berlin 1925.

The man
Einthoven is remembered by most of his physiological colleagues and clinical peers as a very modest person who was profoundly courteous and very hospitable. He could speak three languages fluently as well as his native Dutch and this no doubt helped his influence in international scientific circles.

Einthoven possessed the gift of being able to devote himself entirely to a particular field of study. As a result he was able to make penetrating inquiries into almost any subject which came within the scope of his interests, and to carry out his work to its logical conclusion.

The sporting scientist
Einthoven was a great believer in physical education. In his student days he was a keen sportsman, repeatedly urging his comrades "not to let the body perish". He was President of the Gymnastics and Fencing Union, and was one of the founders of the Utrecht Student Rowing Club. His first study on the elbow joint resulted from a broken wrist suffered while pursuing one of his favourite sports, and during the somewhat involuntary confinement his interest was awakened in the pro- and supination movements of the hand and the functions of the shoulder and elbow joints.

In 1924, while visiting America to give Dungham lectures, Einthoven was awarded the Nobel Prize for physiology or medicine for his discovery of the mechanism of the electrocardiogram. In 1925 he was elected foreign member of Royal Society.

    «The truth is all that matters; what you or I may think is inconsequential.»
    Remark to C. J. Wiggers.

    "We should first endeavour to better understand the working of the heart in all its details, and the cause of a large variety of abnormalities. This will enable us, in a possibly still-distant future and based upon a clear insight and improved knowledge, to give relief to the suffering of our patients."
    Het tele-cardiogram

Bibliography

    Works by persons referred to:
  • G. Lippmann:
    Relations entre les phenomènes électriques et capillaires.
    Ann Chir (Phys.) (Ser. 5) 1875, 5: 494.
  • A.D. Waller:
    An Introduction to Human Physiology.
    2nd edition, New York: Longmans Green, 1893.
  • Clément Ader (1841-1926):
    Sur un nouvel appareil enregistreur pour cables sousmarins.
    Comptes rendus de l'Académie des sciences, Paris, 1897, 124:1440. Willem Einthoven:
  • Quelques remarques sur le méchanisme de l’articulation du coude.
    Archives néerlandaises des sciences exactes et naturelles, 1882, 17: 289-298.
  • Stéréoscopie dépendant d’une différance de couleur.
    Archives néerlandaises des sciences exactes et naturelles, 1886, 20: 361-387.
  • Über die Wirkung der Bronchialmuskeln nach einer neuen Methode untersucht, und über Asthma nervosum. 1892.
  • Lippmann’s Capillarelektrometer zur Messung schnellwechseln der Potentialunterschiede.
    [Pflügers ] Archiv für die gesamte Physiologie des Menschen und der Tiere, 1894, 56: 528-540.
  • Die Registrierung der Herztöne.
    Archiv für die gesamte Physiologie des Menschen und der Tiere, 1894, 57: 617-639.
  • Über den Einfluss des Leitungswiderstandes auf die Geschwindigkeit der Quecksilberbewegungen in Lippmann’s Capillarelektrometer. With M. A. J. Geluk.
    Archiv für die gesamte Physiologie des Menschen und der Tiere, 1895, 60: 91-100.
  • Über die Form des menschlichen Elektrocardiogramms.
    Archiv für die gesamte Physiologie des Menschen und der Tiere, 1895, 60: 101-123.
  • Eine einfache physiologische Erklärung für verschiedene geometrisch-optische Täuschungen. 1898.
  • Beitrag zur Theorie des Capillarelektrometers.
    Archiv für die gesamte Physiologie des Menschen und der Tiere, 1900, 79: 1-25.
  • Eine Vorrichtung zum regsitrieren der Ausschläge des Lippmann’schen Capillarelektrometers.
    Archiv für die gesamte Physiologie des Menschen und der Tiere, 1900, 79: 25-38.
  • Über das normale menschliche Elektrocardiogramm und die capillarelektrometrische Untersuchung einiger Herzkranken.
    Archiv für die gesamte Physiologie des Menschen und der Tiere, 1900, 80: 139-160.
  • Un nouveau galvanomètre.
    Archives néerlandaises des sciences exactes et naturelles, Haarlem, 1901, 2 sér. 6: 625-633.
  • Galvanometrische registratie van het menschilijk electrocardiogram.
    Herinneringsbundel Professor S. S. Rosenstein. Leiden: Eduard Ijdo, 1902: 101-107.
  • Die Accomodation des menschlichen Auges. 1902.
  • Die galvanometrische Registrierung des menschlichen Elektrokardiogramms, zugleich eine Beurteilung der Anwendung des Capillarelektrometers in der Physiologie.
    Archiv für die gesamte Physiologie des Menschen und der Tiere, 1903, 99: 472-480.
  • Ein neues Galvanometer.
    Proceedings of the Koninklijke Nederlandse Akademie van Wetenschappen, Amsterdam, Section of Sciences, 1903-1904, 6: 107-115.
    Annalen der Physik. 4th. series. 1903, 12: 1059-1071.
    Causing a current to flow over a thin conducting thread stretched across a magnetic field, Einthoven discovered that the thread would deviate at right angles to the magnetic lines of force. The sensitivity of this "string galvanometer" enabled him to construct a crude electrocardiograph which could measure the small electric current produced by the action of the heart and eventually to correlate the measurements with various heart diseases. The string galvanometer finally displaced the capillary electrometer.
  • Het tele-cardiogram. Paper, 1906.
  • Die Registrierung der menschlichen Herztöne mittels des Saitengalvanometer.
    Archiv für die gesamte Physiologie des Menschen und der Tiere, 1907, 117: 461-472.
    Phonocardiography.
  • The form and magnitude of the electric response of the eye to stimulation by light at various intensities. With William Adam Jolly, 1908.
  • H.A. Snellen:
    Selected Papers on Electrocardiography of Willem Einthoven. With Bibliography, Biographical Notes and Comments. Dordrecht, Martinus Nijhoff Publishers, October 1977, 306 pages.
    Hardbound, ISBN 90-6021-420-X. Out of Print
  • H.A. Snellen:
    Willem Einthoven (1860-1927). Father of Electrocardiography. Life and Work, Ancestors and Contemporaries. Dordrecht, Kluwer Academic Publishers, December 1994, 144 pages.
    The first book in the English language on Willem Einthoven's life and work.
  • H.A. Snellen:
    Two pioneers of electrocardiography. The correspondence between Einthoven and Lewis from 1908–1926.
    Donker Academic Publications, Rotterdam, 1983. 140 pages.

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