Geddes, L. G. “Historical Perspectives 4 - Electromyography .

”
The Biomedical Engineering Handbook: Second Edition.
Ed. Joseph D. Bronzino
Boca Raton: CRC Press LLC, 2000
 Historical Perspectives 4
Electromyography

Leslie A. Geddes Early Investigations

Purdue University Clinical Electromyography

Early Investigations
The study of bioelectricity started with the Galvani-Volta controversy over the presence of electricity in
frog muscle [see Geddes and Hoff, 1971]. Galvani likened the sciatic nerve-gastrocnemius muscle to a
charged Leyden jar (capacitor) in which the nerve was the inner conductor and the surface of the muscle
was the outer conductor. Therefore, Galvani thought that by joining the two with an arc of dissimilar
metals, the biologic capacitor was discharged and the muscle twitched. Volta proved conclusively that it
was the dissimilar metals in contact with tissue fluid that was the stimulus.
Interestingly, it was found that when the sciatic nerve of a nerve-muscle preparation was laid on the
cut end of another frog muscle and the nerve was touched to the intact surface, the muscle of the nerve-
muscle preparation twitched. Here was evidence of stimulation without metal conductors; this experi-
ment was performed by Matteucci [1842].
With the first galvanometers, it was shown that current would be indicated when one electrode was
placed on the cut end of a frog muscle and the other on the intact surface. This phenomenon became
known as the injury current or frog current, the cut surface being negative to the intact surface.
Whereas the foregoing experiments showed that skeletal muscle possessed electricity, little was known
about its relation to contraction. Matteucci [1842] conducted an ingenious experiment in which he placed
the nerve of a second nerve-muscle preparation on the intact muscle of a first such preparation and
stimulated the nerve of the first using an inductorium. He discovered that both muscles contracted. Here
is the first evidence of the electric activity of contracting skeletal muscle.
Matteucci and DuBois-Reymond both found that the injury current disappeared when a muscle was
contracted tetanically. This observation led directly to the concept of a resting membrane potential and
its disappearance with activity [see Hoff and Geddes, 1957].
That human muscle, as well as frog muscle, produced electric activity was demonstrated by Du Bois-
Reymond [1858] in the manner shown in Fig. HP4.1. With electrodes in saline cups connected to a
galvanometer, Du Bois-Reymond stated that as soon as the fingers were placed in the cups, the galva-
nometer needle deflected, and it required some time for a position of equilibrium to be attained. Du
Bois-Reymond [1858] stated:
As soon as this state [equilibrium] is attained, the whole of the muscles of one of the arms must be
so braced that an equilibrium may be established between the flexors and the extensors of all the
articulations of the limb, pretty much as in a gymnastic school is usually done when one wants to let
a person feel the development of one's muscles.
As soon as this is done, the [galvanometer] needle is thrown into movement, its deflection being
uniformly in such a sense as to indicate in the braced arm "an inverse current," according to Nobili's
nomenclature; that is to say, a current passing from the hand to the shoulder. The braced arm then

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FIGURE HP4.1 The first evidence contracting skeletal muscle in man produces an electrical signal. (From Du Bois-
Reymond [1858].)

acts the part of the copper in the compound arc of zinc and copper mentioned above. [Du Bois-
Reymond was referring to the polarity of a voltaic cell in which zinc and copper are the positive and
negative electrodes, respectively.]
The rheotome and slow-speed galvanometer were used to reconstruct the form of the muscle action
potential. However, it was desired to know the time course of the electric change associated with a single
muscle contraction (twitch), as well as its relationship to the electrical event (action potential). A second
item of interest was the so-called latent period, that time between the stimulus and the onset of muscle
contraction, which Helmholtz [1853] reported to be 10 ms for frog muscle.
Waller [1887] set himself the task of measuring the latent period and the relationship between the
action potential and the force developed by frog gastrocnemius muscle in response to a single stimulus.
He found that the onset of the twitch was later than the onset of the action potential, as shown in
Fig. HP4.2. However, the true form of the muscle action potential and its relationship to the onset of
the twitch had to await the development of the micropipet electrode, the vacuum-tube amplifier, and
the cathode-ray oscilloscope. In 1957, Hodgkin and Horowicz [1957] recorded the twitch and action
potential of a single muscle fiber of the frog. Figure HP4.3 is a copy of their record. Note that the onset
of the action potential precedes the onset of muscle contraction by about 4 ms. We know that it is the
action potential that triggers the release of mechanical energy.

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FIGURE HP4.2 Relationship between the twitch (recorded with a myograph, m) and the action potential (recorded
with a capillary electrometer, e) of a frog gastrocnemius muscle. The time marks (t) are 1/20 s. (From Waller [1887].)

FIGURE HP4.3 The relationship between the muscle action potential and the force of concentration in a single
skeletal muscle fiber in the frog. (From Hodgkin and Horowicz [1957].)

Clinical Electromyography
It was well known that when a nerve that innervates a skeletal muscle is cut, the muscle is paralyzed
immediately; however, days to weeks later (depending on the species), on careful visual examination, the
individual muscle fibers are seen to be contracting and relaxing randomly, i.e., fibrillating. The first to bring
the facts together regarding normal muscle action potentials and denervation-fibrillation potentials were
Denny-Brown and Pennybacker in the United Kingdom [1939]; the date and locale are highly significant.
They distinguished between involuntary twitching of innervated muscle and fibrillation of denervated
muscle by recording both the electric and mechanical activity of muscles. Two instrumental advances made
their study possible: (1) the use of a hypodermic needle electrode inserted into the muscle and (2) the use
of a rapidly responding, mirror-type photographic recorder, the Matthews [1928] oscillograph.
The cathode-ray tube was not generally available in the United Kingdom when Matthews [1928]
constructed his moving-tongue mirror oscillograph. The device consisted of a piece of soft iron mounted
on a steel leaf spring, as shown in Fig. HP4.4. A strong electromagnet attracted the soft iron, which bent

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FIGURE HP4.4 The Matthews moving-tongue oscillograph and amplifier used with it. The electromagnetic coil (A)
provided an attractive force on the tongue (soft iron and steel spring); the signal current applied to the small coils
aided or opposed this force and caused the tongue to bend more or less and hence move the mirror which reflected
a beam of light on to a recording surface. (From BHC Matthews, 1928, J. Physiol (Lond) 65:225, with permission.)

the steel (leaf-spring) support. Two coils mounted on the pole faces were connected to the output tubes
of a five-stage, single-sided, resistance-capacitance coupled amplifier. The amplified potentials altered
the current in the electromagnet coils, causing more or less bending of the leaf spring, thereby tilting the
mirror mounted on the leaf spring and permitting photographic recording of action potentials.
With the Matthews oscillograph, Denny-Brown and Pennybacker [1939] laid the foundation for clinical
electromyography when they reported as follows:
Denervated muscle fibers contract periodically, and the confused medley of small twitches constitutes
true fibrillation. The movement is so slight that it can seldom be seen in the clinic. The twitchings
appear to be due to heightened excitability of the sarcolemma or rapidly conducting portion of the
muscle fibre to traces of free acetylcholine in the tissues.
Reinnervated muscle is free from such involuntary excitation, except for the curious "contracture"
of facial muscle, which consists of periodic, intense repetitive discharges which suggest a central
mechanism.

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 Earlier it was stated that 1939 was significant; this was the year when World War II broke out in Europe.
Soon motor nerve injuries due to shrapnel wounds began to appear in large numbers, and the need for
electromyography to identify denervation fibrillation potentials and their gradual disappearance with
reinnervation was urgent. The first electromyograph in North America was developed by Herbert Jasper
at McGill University (Montreal Neurological Institute). Starting in 1942, design concepts were developed,
and by 1944 prototypes had been built and used clinically. In his report to the Committee on Army
Medical Research, Capt. Jasper [1945] stated:
The present equipment has been developed over a period of about 18 months experimentation with
different designs of electromyograph for use on hospital wards. Numerous modifications of design
have been incorporated in the present model in order to provide simplicity of operation, portability,
freedom from electrical interference, and perfection of both the audible and visible analysis of the
electrical activity of normal and diseased muscles. A portable clinical electromyograph has been
developed which has proven to be practical in operation on hospital wards to aid in the diagnosis and
prognosis of muscles paralyzed by traumatic injuries of their nerve supply. Four complete units have
been constructed for use in special centers for the treatment of nerve injuries.
The Royal Canadian Army Medical Corps (RCAMC) electromyograph had many unique design
features that were incorporated in all later commercially available electromyographs. It consisted of three
units, a small battery-operated three-stage differential amplifier (Fig. HP4.5) and an oscilloscope
(Fig. HP4.6), both placed on a loudspeaker cabinet on rubber-wheel casters (Fig. HP4.7). Thus simulta-
neous visual display and aural monitoring of normal motor units and fibrillation potentials was possible.
The preamplifier (Fig. HP4.5) was very carefully constructed, the input tubes being supported by
rubber-mounted antimicrophonic sockets. The grid resistors (R9) and plate resistors (R8) were wire
wound and carefully matched. A high common-mode rejection ratio was obtained by matching the input
tubes and adjustment of the potentiometer (R7) in the screen-grid supply. A common-mode rejection
ratio in excess of 10,000 was easily achieved. The overall frequency response extended from 3 to 10,000 Hz.
The cathode-ray oscilloscope (Fig. HP4.6) was of unusual design for that time because the sweep
velocity was independent of the number of sweeps per second, a feature to appear much later in
oscilloscopes. A linear sweep (time base) was obtained by charging a capacitor (0.1 µF) through a pentode
(6U7G) which acted as a constant-current device. The sweep was initiated at a rate of about 7 times per
second by the multivibrator (6N7), which also provided an output to enable stimulating a nerve, the
stimulus occurring at the beginning of each sweep, thereby permitting nerve conduction-time measure-
ments. The oscilloscope also contained the audio amplifier (6L6). The cathode-ray tube had a short-
persistence, blue-white phosphor that produced brilliant blue-white images of remarkable clarity. A
camera was used to obtain photographic records of the waveforms, which were optimized by listening
to them via the loudspeaker (as advocated by Adrian) as the needle electrode was being inserted and
adjusted. Fig. HP4.8 illustrates typical action potentials.
At the end of the war (1945), oscilloscopes became available, and Fig. HP4.7 shows the RCAMC
electromyograph with a Cossor oscilloscope (right) and the high-gain differential amplifier (left), both
on the loudspeaker cabinet, which was on casters. The recessed opening at the top of the loudspeaker
cabinet face provided access to the on-off and volume controls.
In addition to the creation of a high-performance EMG unit, Jasper introduced the monopolar needle
electrode system used in all subsequent EMGs. The needle electrode was insulated with varnish down to
its tip and was paired with a skin-surface electrode of silver. The patient was grounded by another electrode
taped to the same member that was being examined. Figure HP4.8 illustrates application of the electrodes
and typical motor-unit and fibrillation potentials. The report by Jasper and Ballem [1949] summarized
the experience with the RCAMC electromyograph and laid the foundation for diagnostic EMG.
World War II ended in 1945, after which electromyographs became available commercially. Their
features were essentially the same as those embodied in the RCAMC electromyograph. From the begin-
ning, these units were completely power-line-operated, the author's master's thesis describing the first
of these units.

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FIGURE HP4.5 The three-stage resistance-capacity coupled differential amplifier used is the RCAMC electromyo-
graphy. (From Jasper et al. [1945].)

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FIGURE HP4.6 The oscilloscope, loudspeaker amplifier, and stimulator unit of the RCAMC electromyograph.
(From Jasper et al. [1945].)

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 FIGURE HP4.7 A later version of the RCAMC elec-
tromyograph showing the high-gain preamplifier (left)
and oscilloscope (right) on top of the loud-speaker cabinet.

FIGURE HP4.8 Electrode arrangement and action potentials with the RCAMC electromyograph. (Redrawn from
Jasper and Ballem [1949].)

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References
Denny-Brown D, Pennybacker JB. 1939. Fibrillation and fasciculation in voluntary muscle. Brain 61:311.
Du Bois-Reymond E. 1858. Untersuchungen uber thierische Elekticitat. Moleschott's Untersuch. Z Natur
Mensch 4:1.
Geddes LA, Hoff HE. 1971. The discovery of bioelectricity and current electricity (the Galvani-Volta
controversy). IEEE Spect 8(12):38.
Helmholtz H. 1853. On the methods of measuring very small portions of time and their application to
physiological purposes. Philos Mag J Sci 6:313.
Hodgkin AL, Horowicz P. 1957. The differential action of hypertonic solutions on the twitch and action
potential of a muscle fiber. J Physiol (Lond) 136:17P.
Hoff HE, Geddes LA. 1957. The rheotome and its prehistory: A study in the historical interrelation of
electrophysiology and electromechanics. Bull Hist Med 31(3):212.
Jasper HH, Ballem G. 1949. Unipolar electromyograms of normal and denervated human muscle.
J Neurophysiol 12:231.
Jasper HH. 1945. The RCAMC electromyograph, Mark II. With the technical assistance of Lt. RH Johnston
and LA Geddes. Report submitted to the Associate Committee on Army Medical Research, National
Research Council of Canada, 27 April 1945.
Matteucci C. 1842. Duxieme memoire sur le courant electrique propre de la grenouille et sur celui des
animaux a sang chaud. Ann Chim Phys 3S(6):301.
Matthews BHC. 1928. A new electrical recording system for physiological work. J Physiol (Lond) 65:225.
Waller AD. 1887. A demonstration on man of electromotive changes accompanying the heart's beat.
J Physiol (Lond) 8:229.

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