Einthoven’s Machine Is Alive and Well
Today, Although His Contemporaries
Were Not Interested In It At All
To the Editor:
I read with interest Soffer’s editorial in CHEST (August 2005)1
on Einthoven’s invention of the ECG machine, particularly the
title of the editorial “Einthoven’s Machine, Alive and Well.” It
might be of interest from an historical standpoint to go back to
Einthoven’s time. As was noted by Dock in his 1980 postcard to
this author (Fig 1), “the internists of Amsterdam, Leiden, the
Hague were not interested in Einthoven’s galvanometer.”
Einthoven’s contemporary Wenckebach (Einthoven, 1860 –1927;
Wenckebach, 1864 –1940) experienced the same fate. As Dock
continued in his postcard, “Wencke, with whom I studied in Vienna,
described all the classic patterns except those of infarction. In 1979,
when we visited [the] ECG lab of his hospital, no one had ever heard
of him.” Dock went on to conclude his card by saying, “Such is fame,
Sutton & Dock will go same way.” Here, of course, Dock was
referring to his famous “Sutton’s Law.”2
Tsung O. Cheng, MD, FCCP
George Washington University
Washington, DC
Reproduction of this article is prohibited without written permission
from the American College of Chest Physicians (www.chestjournal.
org/misc/reprints.shtml).
Correspondence to: Tsung O. Cheng, MD, FCCP, George Washington University, Division of Cardiology, 2150 Pennsylvania Ave, NW,
Washington, DC 20037-3201; e-mail: [email protected]
References
1 Soffer A. Einthoven’s machine, alive and well. Chest 2005;
128:487– 488
2 Cheng TO. William Dock. Am J Cardiol 1999; 84:1212–1225
Use of Racemic Epinephrine in
Bronchiolitis
What Is the Emergency Physician’s
Perspective?
To the Editor:
Bronchiolitis is the most common lower respiratory tract
infection in infants. Many aspects of its treatment are controversial. Therapy with inhaled racemic epinephrine relieves airway
obstruction in patients with respiratory syncytial virus bronchiolitis. We conducted a study to find out about the current usage
of racemic epinephrine in patients with bronchiolitis.
One hundred emergency departments (EDs) were sent a
four-part questionnaire by mail. The questionnaires were mailed
to the director of the ED at each facility and inquired about their
practice regarding the use of racemic epinephrine using the
following four questions:
1. Do you use nebulized racemic epinephrine as a first-line
agent in bronchiolitis?
2. In which patients do you choose to use nebulized racemic
epinephrine?
3. Do you admit all children with bronchiolitis who have
received nebulized racemic epinephrine?
4. What do you prescribe at the time of discharge?
The response rate was 78%. Over 85% of the physicians who
responded do not use racemic epinephrine as a first-line agent.
More than two thirds of physicians (84.6%) reserved this agent
for treating patients with moderate-to-severe illness. Sixty-two
percent of those who responded admit to the hospital those
children who have received racemic epinephrine. Fifty-two
percent of physicians prescribed albuterol in a metered-dose
inhaler, 22% prescribed normal saline solution, and 26% prescribed nothing at the time of hospital discharge.
Figure 1. Postcard from Dock to this author in 1980 about Einthoven.
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Correspondence