Willem Einthoven (1860-1927), Professor of Physiology at the University of Leiden, invented the 'string galvanometer' with which he used practically useful ECGs, but also developed the 'interpretation terminology'. During the 'First International Congress of Physiologists' of 1889 in Basel, Einthoven was greatly impressed by a demonstration by the British physiologist August Désiré Waller (1856-1922) and his faithful dog. With the aid of the Lippmann electrometer, Einthoven started registering heart tones in 1893. He called the obtained curves 'cardiophonogram'. The precision of the registration was so great that he succeeded in showing the 'third heart tone' in the curves, which George Alexander Gibson (1854-1913) thought to observe when listening to the heart. Einthoven, however, was more interested in cardiography, so he ignored the phonocardiology. Despite the improvements he added, working with the capillary electrometer remained far too cumbersome.
One of the first ECGs of Einthoven
Einthoven went in search of a better measuring instrument and turned his attention to the galvanometer of the French physician Jacques Arsène Deprez-d'Arsonval (1851-1940) from which he developed the string galvanometer. He published his invention in his paper 'Galvanometer registration of the human electrocardiogram'. The device consisted of a very thin quartz wire, provided with a conductive silver layer, which was stretched vertically between two strong electromagnets. When a current flowed through the wire, the magnetic field caused it to move. The deflection of the wire was enlarged via a microscope and then continuously recorded on a rotating roll of photographic paper.
The Einthoven lab with the string galvanometer
The original string galvanometer had water-cooled electromagnets. There were five people needed to serve it and with its 300 kilos it was far to heavy to be moved. The patients had to be taken to the device, but Einthoven was not given permission by the hospital management because most patients were too weak. Reason why he connected the patient and his string galvanometer to a telephone line.
The illustration of a comparison of three consecutive episodes of an electrocardiographic development.
In the Einthoven ECG model, the cardiac source was a bi-dimensional dipole in a fixed location within a volume conductor that was either infinite and homogeneous, or a homogeneous atmosphere with a bipolar source in the middle. Einthoven first recognized that no significant electrocardiographic flows could be admitted from the breast, because the limbs were thin and long. Consequently, he realized that the potential on the wrist was the same as that of the upper arm, while that was the same on the ankle as on the thigh. So he assumed that the functional measurement positions of the left leg and the right and left arm corresponded to the points on the chest, which successively revealed a geometric relationship approaching the apexes of an equilateral triangle. He also assumed that the heart generator could be approached as a single dipole with fixed position, but the magnitude and orientation of which could differ. The location of the heart dipole was chosen for the convenience as the center of a triangle relative to the derivations. The signals were obtained from the two arms and the left leg (modern lead I). To increase the conduction, the hands and feet were dipped in a bath with saline solution.
Georges Demeny (1850-1917), professor of physical education and head of l'Institut de physiologie du Collège de France', published in 1901 'Les bases scientifiques de l'éducation physique', a book that indicated the way to follow in sports medicine research, and two years later: 'Mécanisme et éducation des mouvements'.
In the early 1900s the focus shifted from measuring body parts to testing the vital working capacity. For example, in 1903 American physiologist Thomas Andrew Storey (1875-1940) tested the influence of fatigue, in 1901 American physiologist James Huff McCurdy (1852-1921) and Canadian physician R. Tait McKenzie (1867-1938) in 1913 of the blood pressure and in 1914 American physiologist WL Foster the influence of the heartbeat.
According to German physiologist Nathan Zuntz (1847-1920) it was of vital importance that scientific conclusions should not be based solely on data collected in a lab, but that they also have to be confirmed with field tests and vice versa.
This procedure method was clearly expressed in his book 'Studien zu einer Physiologie des Marsches' (Studies on the physiology of marching), which he published in 1901 together with his colleague William Schumburg (1882-1962). They investigated marching with Prussian soldiers and developed several devices.
With these devices, they were able to measure blood pressure, heart rate, respiratory rate and vital capacity, and found that there was a significant limitation and marked reduction in airway performance during marching.
In September 1901 Zuntz presented his new portable gas meter at the fifth International Congress of Physiology in Turin. To measure the wind speed he wore a cap to which an anemometer was attached.
The American company Spalding, known for its sports equipment, started with the production of rowing ergometers.