The Wire from the Hospital

1905 · String Galvanometer Telecardiogram · Work 1002 of 1,871

A physiology laboratory in Leiden on a grey March forenoon, on a heavy stone pillar a squat galvanometer fifty-eight centimetres long on a dark grey cast-iron base, between two iron cheeks a thick magnet coil wound tight with cream-white linen tape, above it a frame of black iron and brass with adjusting screws, at one end a brass block with a short microscope tube and knurled knobs, beside it a black tin arc lamp and a tall wooden camera cabinet, two green cloth-covered telephone wires entering through the window frame to a board of bare brass terminals, and standing at the far side of the pillar, between the galvanometer and the window, the man, a living figure in the scene and the only person in the room, a bald man of forty-four with a full dark beard flecked with grey, in a dark wool three-piece suit and a white stiff collar, full height and in proportion to the pillar and the cabinet, one hand on a knurled knob, his face turned toward the camera in three-quarter view, wet brick roofs beyond the window.

Who
Willem Einthoven (1860–1927) was a Dutch physician and physiologist who turned the electrocardiogram into a working tool of medicine. Born on 21 May 1860 in Semarang on Java, then part of the Dutch East Indies, he lost his father, an army doctor, at the age of six; in 1870 his mother moved with her six children to Utrecht. There he studied medicine, paid for by the army on condition that he would afterwards serve as a military doctor in the colonies. When he was given the chair of physiology at Leiden in 1886, he was able to buy himself out of that obligation for 6,000 guilders. From 1901 he built the string galvanometer: a silver-coated quartz thread in a strong magnetic field follows the faint currents of the heart, and its shadow, greatly magnified, is photographed on film. He named the peaks of the curve P, Q, R, S and T. In 1924 he received the Nobel Prize in Physiology or Medicine. He gave half of the prize money to the impoverished sisters of his late assistant Van de Woerd, who had built many parts of the instrument. Einthoven died on 29 September 1927. The ECG is still the most commonly used laboratory test for evaluating conduction disorders and ischaemic heart disease.
The moment
On 22 March 1905 the first "telecardiogram" was recorded in Leiden. The string galvanometer weighed just over 270 kilograms and could not be taken to the hospital, and it was hard for patients to come to the laboratory. So Einthoven brought the heart currents into his physiological laboratory over the lines of the city telephone network, about one and a half kilometres from the Academisch Ziekenhuis. The electrodes of the time were buckets of salt solution in which hands and feet were immersed. By Einthoven's own description, the first person at the other end of the line was a healthy, vigorous man. In the laboratory the quartz thread wrote the curve on film. The picture shows this end of the line: the squat galvanometer with its linen-wound coil, the arc lamp and camera beside it, the wires at the window, and Einthoven behind the pillar. It is his first galvanometer of 1901, which survives in the Rijksmuseum Boerhaave in Leiden.
The other side
Progress hung on a telephone bill. The line cost money, and Einthoven's laboratory and the hospital's department of medicine shared the cost until its head one day stopped paying and the connection was ended. Five people were needed to operate the instrument. Einthoven held no patent, because the Netherlands had no patent law from 1869 to 1910. Firms in Cambridge and Munich built and sold the instrument; the Cambridge firm improved it and in 1905 delivered one to a physiological laboratory in Sheffield.

What the sources leave open: No source states outright that Einthoven himself was at the instrument on 22 March 1905; it is inferred. Whether this surviving galvanometer was the one used that day, how the line entered the laboratory and at what time of day the recording was made is not recorded. The IEEE milestone calls the first subject a patient, Einthoven's own report a healthy man. His face follows a photograph of 1898, seven years before the moment; room, pillar and clothing are typified.

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