Inge Edler: the Father of Echocardiography

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Professor Inge Edler, born 1911, has passed away a few days before his 90th birthday. Following medical studies at the University of Lund, Sweden and general medical training, he was employed at the Department of Medicine, Malmo General Hospital in 1944 and became responsible for its cardiac catheterization laboratory in 1948. From 1950 to 1960 he had the corresponding task at the Lund University Hospital. After a short stay in a small countryside hospital he was appointed head of the Department of Cardiology at Lund University Hospital in 1963, where he stayed until his retirement in 1977. During the years in Malmo, Edler worked together with Professor Helge Wulff, one of the pioneers within the field of cardiac surgery. Closed mitral commisurotomy had evolved as an important surgical method, and Edler soon identified the need for improved preoperative diagnostic methods. Initiated by the use of the Radar technique during World War II, he considered the possibility of using some kind of echo technology for this purpose. After contacts with Jan Cederlund, a physicist in Lund, he started a cooperation with another physicist, Hellmuth Hertz, who was familiar with the so-called ultrasonic reflectoscope, developed for non-destructive material testing by the Firestone Co, USA. Hertz was aware of an ultrasonic reflectoscope at a shipyard in Malmo and borrowed the device during a weekend in May 1953. When Edler and Hertz placed the transducer of the reflectoscope over the chest they could detect moving echoes, obviously originating from the movements of the heart. Hertz then managed to arrange a long-term loan of an ultrasonic reflectoscope from the Siemens Co, Germany. This instrument was used for an intense evaluation of the new method in vitro and in vivo. To be able to analyse the ultrasound recordings, a special device for continuous recording of the movements of echo-producing structures in the heart was developed (M-mode recording). On 29 October 1953 Edler and Hertz recorded the first ‘‘ultrasound cardiogram’’, and published their findings the following year. The clinical evaluation of the method in adult cardiology was then performed by Edler and co-workers at the University Hospital in Lund (Arne Gustavsson, Tord Jarlefors, Bo Christensson and Olle Dahlback) and in paediatric cardiology by Nils-Rune Lundstrom at the same hospital. The evaluation was a most difficult task, including anatomical and physiological studies and of course also an enourmous amount of careful, timeconsuming examinations of patients. Edler did not exactly know what to look for, he had no two-dimensional