The electrocardiogram – or ECG – fulfils the requirements for a diagnostic test: non-invasive, easy to record and reproducible. It is applied to patients with chest pain or irregular heart beat and used prognostically to predict the likely course of a cardiac condition. Among the early pioneers in the development of the ECG was the Dutch physician Willem Einthoven who in 1924 was awarded the Nobel Prize in Medicine or Physiology “for the discovery of the mechanism of the electro-cardiogram.”
The story of a young South African’s contribution to the ECG is told in the book In Search of Truth by EB Adams, which has the subtitle, A Portrait of Don Craib. William Hofmeyr Craib, known affectionately as ‘Don’, was born in Somerset East in 1895, educated at the South African College – now the University of Cape Town – and earned an honours degree in mathematics, applied mathematics and physics in 1914. Although his intention was to become an engineer, after serving with distinction in the First World War, Craib (seen below left) studied first at Cambridge before qualifying in medicine at Guy’s Hospital in London.
A Rockefeller Fellowship took him to the Johns Hopkins Hospital in Baltimore in 1925 where he studied the ECG action potentials recorded on isolated animal heart muscle. As DP Naidoo noted, “From his experiments, Craib formulated his doublet hypothesis, referring to the wave of excitation that passes down the muscle tissue across a series of interfaces as a succession of doublets, each of which is so arranged that a positive pole is a short distance ahead of the negative pole.”
Craib had no idea that his doublet hypothesis would be bitterly opposed by the experts. At a physiological congress in 1926, Einthoven adjourned one session to avoid discussion: “He told Craib that his results were at odds with fact and theory, possibly faked, and criticised him for impertinence, rudeness and for wasting delegates’ time with nonsense, heresy and rubbish.” Forbidden from continuing his research at Hopkins, he returned to England where he continued his work in the laboratory of the pioneering cardiologist, Sir Thomas Lewis.
Craib published his theory and experimental data in Heart and the Journal of Physiology in 1927-28 but, after falling out with Lewis, he returned to South Africa with a deep sense of failure and rejection. It took 50 years but Don Craib was finally vindicated, receiving an apology and being reinstated to the Society of Fellows at Johns Hopkins in 1977. In the end, his search for truth had prevailed.