Einthoven, Willem

Einthoven, Willem

(b. Semarang, Java, 21 May 1860; d. Leiden, Netherlands, 28 September 1927)

physiology.

Einthoven’s father was municipal physician of Semarang; he married Louise M. M. C. de Vogel. He died in 1866, and four years later his widow settled in Utrecht with their six children. There Willem Einthoven graduated from high school and registered as a medical student in 1879. In 1886 he married his cousin Frédérique Jeanne Louise de Vogel; they had three daughters and a son.

While a student, Einthoven was active in sports; when he broke his wrist in a fall, he made it the occasion to publish a study on the pronation and supination of the forearm (1882). On 4 July 1885 he received the Ph.D in medicine cum laude with a thesis on stereoscopy through color differentiation. The following December he was appointed professor of physiology at Leiden.

In 1895, after the London physiologist A. D. Waller had published the curve for the action current of the heart as deduced from the body surface and had announced that he was unable to calculate its true shape (as recorded with Lippmann’s capillary electrometer), Einthoven repeated this experiment. He defined the physical constants of the capillary electrometer and calculated the true curve, which he called the electrocardiogram. Einthoven considered direct registration of the curve’s true curve, which he called the electrocardiogram. Einthoven considered direct registration of the curve’s true shape a necessity. Starting from the mirror galvanometer of Deprez-d’ Arsonval, he arrived at his brilliant conception of the string galvanometer. In 1896, while working on the construction of this instrument and developing the necessary photographic equipment, he registered electrocardiograms with the capillary electrometer as well as heart sounds of humans and animals.

For making electrocardiograms Einthoven chose the ordinate and abscissa in such a way that all details of the electrocardiogram would appear as clearly as possible. In 1903 he defined the standard measures for general use—one centimeter movement of the ordinate for one millivolt tension difference and a shutter speed of twenty-five millimeters per second, so that one centimeter of the abscissa represented 0.4 second. He indicated the various extremes by the random letters P, Q, R, S, and T and chose both hands and the left foot as contact points. This gave three possible combinations for contact which he labeled I (both hands); II (right hand-left foot); and III (left hand-left foot).

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. Einthoven referred to this as the manifest size and direction of the electrical axis. He indicated the direction by the angle α of the axis with the horizontal and called it positive when it turned clockwise, negative when counterclockwise. 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 1.5 kilometers long (1906).

These “telecardiograms” acquainted Einthoven with many forms of heart disease. In addition he deepened his insight by registering heart sounds and murmurs simultaneous to the electrocardiogram by means of a second string galvanometer. The construction of a string recorder and a string myograph, both based on the torsion principle, enabled him to prove that the electrocardiogram and muscle contraction are inseparably connected.

While visiting America to give the Dungham lectures (1924) Einthoven was awarded the Nobel Prize for physiology or medicine. Upon his return to Leiden he found two foreign requests to register the action currents of the cervical sympathetic nerve. With the newly constructed vacuum string galvanometer he succeeded, on 28 April 1926, in registering the tonus action current and, after irritation of the organ, the thereupon induced action current of the cervical sympathetic nerve. His last major physical experiment, which he carried out in company with his son, was concerned with the reception of radiotelegrams broadcast by the machine transmitter “Malabar” in Java. In this case the string of 0.1 micron diameter and six millimeters length and to be synchronized with the 40,000 vibrations of the transmitting wave. Einthoven and his son found the resonance point after they achieved a variation in tension of one micro micron, after which telegrams from the machine transmitter, working at top speed, were perfectly photographed on paper one centimeter wide.

Einthoven’s last work was his treatise on the action current of the heart, which appeared posthumously in Bethe’ Handbuch der normalen und pathologischen Physiologie.

BIBLIOGRAPHY

I. Original Works. Einthoven’s works include “Quelques remarques sur le mécanisme de l’articulation du coude”, in Archives nėerlandaises des sciences exactes et naturelles, 17 (1882), 289–298; “Stéréscopie dépendant d’une différence de couleur”, ibid., 20 (1886), 361–387; “Lippmann’s Capillarelektrometer zur Messung schnell wechseln der Potentialunterschiede”, in Pflügers Archiv für die gesamte physiologie des Menschen und der Tiere, 26 (1894), 528–540; “Die Registrierung der Herztöne”, ibid., 57 (1894), 617–639, written with M. A. J. Geluk; “Über den Einflusz des Leitungswiderstandes auf die Geschwindigkeit der Quecksilberbewegungen in Lippmann’s Capillarelektrometer”, ibid., 60 (1895), 91–100; “Über die Form des menschlichen Elektrocardiogramms”, ibid,. 101–123; “Beitrag zur Theorie des Capillarelektrometers”, ibid., 79 (1900), 1–25; “Eine Vorrichtung zum Registrieren der Ausschlage des Lippmann’schen Capillarelektrometers”, ibid., 25–38; “Über das normale menschliche Elektrokardiogramm und die capillarelektrometrische Untersuchung einiger Herzkranken”, ibid,. 80 (1900), 139–160, written with K. de Lint; “Un nouveau galvanométre” in Archives néerlandaises des sciences exactes et naturelles, 6 (1901), 625–633; “Die galvanometrische Registrierung des menschlichen Elektrokardiogramms, zugleich eine Beurteilung der Anwendung des Capillarelektrometers in der Physiologie”, in Pflügers Archiv für die gesamte physiologie des Menschen und der Tiere, 99 (1903), 472–480.

See also “Über einige Anwendungen des Saitengalvanometers”, in Annalen der Physik, 14 (1904), 182–191; “Über eine neue Methode zur Dämpfung oszillierender Galvanometerausschlage,” ibid., 16 (1904), 20–32; “Weitere Mitteiloungen Uber das Saitengalvanometer. Analyse der saitengalvanometrischen Kurven. Masse und Spannug des Quarzfadens und Widerstand gegen die Fadenbewegung”, ibid., 21 (1906), 483–514, 665–701; “Le télécardiogramme”, in Archives Internationaldes de Physiologie, 4 (1906), 132–165; “Die Registrierung der menschlichen Herztöne mittels des Saitengalvanometers”, in Pflugers Archiv für die gesamte Physiologie des Menschen und der Tierre, 117 (1907), 461–472, written with A. Flohil and P. J. J. A. Battaerd; “Ein dritter Herzton”, ibid., 120 (1907), 31–43, written with J. H. Wieringa and E. P. Snijders; “Weiteres öber das Elektrokardiogramm”, ibid., 122 (1908), 517–585, Written with B. Vaandrager; “Die Konstruktion des Saitengalvanometers”, ibid., 130 (1909), 287–321; “Über die Deutung des Elektrokardiogramms,” ibid 149 (1913), 65–86, “Eine Vorrichtung zur photographischen Registrierung der Zeit,” in Zeitschrift für biologische Technik und Methodik, 3 (1912),1–8; and “Über die Richtung und die manifeste Grösse der Potentialschwankungen im menschlichen Herzen und über den Einfluss der Herzlage auf die Form des Elektrokardiogramms,” in Pflügers Archiv für die gesamte Physiologie des Menschen und der Tierre, 150 (1913), 275–315, written with G. Fahr and A. de Waart.

Subsequent works are “On the Variability of the Size of the Pulse in Cases of Auricular Fibrillation,” in Heart, 6 (1915), 107–121, written with A.J. Korteweg; “Die gleichzeitige Registrierung elektrischer Erscheinungen mittels zwei oder mehr Galvanometer und ihre Anwendung auf die Elektrokardiographie,” in Pflügers Archiv fürdie gesamte Physiologie des Menschen und der Tiere, 164 (1916), 167–198, written with L. Bergansius and J. Bijtel; and “Über den Zusammenhang zwischen Elektro-und Mechanodardiogramm,” in Berichte über die gesamte Physiologie und experimentelle Pharmakologie, 2 (1920), 178.

His last works include “L’électrocardiogramme tracé dans le cas où il n’y a pas de contraction visible du coeur,” in Archives néerlandaises de physiologie de l’homme et des animaux, 5 (1921), 174–183, written with F. W. N. Hugenholtz; “Über die Beobachtung und Abbildung dönner Faden,” in Pflügers Archiv für die gesamte Physiologie des Menschen und der Tiere, 191 (1921), 60–98; “Über Stromleitung durch den menschilchen Körper,” ibid., 198 (1923), 439–483, written with J. Bijtel; “Functions of the Cervical Sympathetic Manifested by Its Action Currents,” in American Journal of Physiology, 65 (1923), 350–362, written with Joseph Byrne; “The Relation of Mechanical and Electrical Phenomena of Muscular Contraction, With Special Reference to the Cardiac Muscle,” in The Harvey Society Lectures (Philadelphia-London, 1924–1925), pp. 111–131; “Das Saitengalvanometer und die Messung der Aktionsströme des Herzens,” in Les Prix Nobel 1924–1925 (Stockholm, 1926), p. 18, his Nobel Prize acceptance speech; “Gehirn und Sympathicus, die Aktionsstrome des Hallsympathicus,” in Pflügers Archiv für die gesamte Physiologie des Menschen und der Tiere, 215 (1927), 443–453, written with S. Hoogerwerf, J. P. Karplus, and A. Kreidl; and “Die Aktionsstrome des Herzens,” in Bethe’s Handbuch der normalen und pathologischen Physiologie, 8 (1928), 785–862.

II. Secondary Literature. On Einthoven and his work see S. L. Barron, Willem Einthoven, Biographical Notes, Cambridge Monograph no. 5 (London, 1952), pp. 1–26; F.L. Bergansius, “Willem Einthoven,” in Wetenschappelijke bladen, 1 (1925), 257; A. V. Hill, “Obituary. Prof. W. Einthoven,” in Nature, 120 (1927), 591–592; Leonard Hill, “Willem Einthoven;” in British Medical Journal (1927), 2 , 665; S. Hoogerwerf, Leven en Werken van Willem Einthoven (Hoorn, 1925), 9–93; and “Willem Einthoven,” in T. P. Sevensma, ed., Nederlandsche Helden der Wetenschap (Amsterdam, 1946), 239–297; J. E. Johansson, “W. Einthoven (1924–1925),” in Les Prix Nobel Nobel 1924–1925 (Stockholm, 1926); C.L. de Jongh, “Het levenswerk van Einthoven,” in Nederlandsh tijdschrift voor geneeskunde, 98 (1954), 270–273; T. Lewis, “Willem Einthoven,” in British Medical Journal (1927), 2 664–665; G. van Rijnberk, “Willem Einthoven,” in Nederlandsch tijdschrift voor geneeskunde, 68 (1924), 2424–2430; “In Memoriam,” ibid., 71 (1927), 1502–1503; E. Schott, “Willem Einthoven und die Fortschritte, welche wir der Erfindung des Saitengalvanometers verdanken,” in Münchener medzinische Wochenschrift, 72 (1925), 391–392; A. Sikkel, “In Memoriam W. Einthoven,” in Geneeskundige gids, 5 (1927), 925; “Nectologie Einthoven,” in University of Leiden, Jaarboek, 1928; A. de Waart, Einthoven (Haarlem, 1957), with a complete list of his works; K. F. Wenckebach, “W. Eionthoven,” in Deutsche medizinische Wochenschrift, 51 (1927), 2176; F. A. F. C. Went, “Herdenkingsrede,” in Verslagen van de gewone vergadering van de Koninklijke Nederlandsche Academie van Wetenschappen. Afdeling Natuurkunde, 8 (1927), 936–938; and H. Winterberg, “W. Einthoven,” in Wiener klinische Wochenschrift, 40 (1927), 1460–1461.

S. Hoogerwerf