This is an interesting and timely study of the life and contributions of Willem Einthoven, the Dutch physiologist who invented the electrocardiograph. It complements Snellen’s earlier books in which he collected several of Einthoven’s scientific papers and published an annotated selection of his correspondence.
Snellen describes Einthoven’s life and surveys his research, beginning with his studies on the physiology of vision and respiration. He also details the development of Einthoven’s interest in electrophysiology. Einthoven first reported his invention of a string galvanometer that could record the heart’s electrical impulse in 1902 in a Dutch festschrift. This little known publication preceded a German translation of the paper that appeared the following year. It was apparent very soon that the electrocardiograph was a powerful tool for studying cardiac electrophysiology in animals and humans. Within a decade, Einthoven’s large and complex string galvanometer had migrated from the physiologist’s laboratory to the hospital, where electrical cables connected it to patients.
Snellen’s book provides an interesting perspective on Einthoven’s interactions with several other pioneers of electrocardiography who were defining the role of the instrument in research and patient care. There are transcriptions and translations from letters between Einthoven and other persons who shared his interest in electrophysiology and electrocardiography, such as Frans Donders, Thomas Lewis, A. de Waart, Augustus D. Waller, and Karel Wenckebach.
The sections devoted to the contributions to electrocardiography of Lewis [End Page 170] and Waller and their relationship to Einthoven are especially interesting. A British physician and clinical scientist, Lewis was the first person in the English-speaking world to acquire an electrocardiograph (in 1909). During the next decade, his laboratory at University College Hospital, London, became a magnet for aspiring heart specialists and a factory of new knowledge as a result of his passion for research and his possession of the instrument.
Meanwhile, however, the electrocardiograph contributed to tensions that had been developing in medicine for decades. Although many physicians embraced the new diagnostic techniques introduced around the turn of the century, some practitioners and professors were skeptical of (or openly hostile to) the growing emphasis on technology and laboratory tests. The trend toward objectifying the diagnostic process was unrelenting, however. Diagnostic tools like the electrocardiograph also helped to define certain types of medical specialists. This phenomenon can be traced to the invention of the ophthalmoscope in 1851 and its impact on the growth of ophthalmology as a specialty. Between the First and Second World Wars, the simple possession of an electrocardiograph and the ability to interpret the tracings it generated were often sufficient to differentiate a cardiologist from a general internist in the United States.
As we approach the centennial of the electrocardiograph, Snellen’s new book is a road map to the contributions of early workers in the field of electrocardiography. It includes several interesting illustrations and a bibliography of 123 primary and secondary sources. Snellen also evaluates several recent biographical sketches of Einthoven and papers on the history of electrocardiography.