MARTYRS TO RADIOLOGY
It was not until several years after the discovery of X-rays by
Roentgen, in December, 1895—after operators had been severely burned
in laboratories and hospitals all over the world, and surgeons and
physicians began to compare notes, that the pathological effects of
X-rays were discovered and understood.
Says John Macy (in his memorial volume on Walter James Dodd, heroic
victim of 50 separate operations due to X-ray burn):
“It is easy now to understand what was happening to Dodd and his
contemporaries. In a modern X-ray machine the strength of the current,
the quality of the spark, all the conditions, are determined by
metrical instruments. In the early days the operator tested his tube
and adjusted it by throwing the shadow of his hand on the fluoroscope;
by the look of the shadow he judged how the machine was behaving. First
he used the left hand until that became too sore, then the right. And
until devices were found to focus and confine the rays, the face of the
operator was exposed, and sometimes the neck and chest were burned.
A limited exposure to the X-ray is as harmless as a walk in the
sunlight. It is the repeated, continuous bombardment of the ray that is
calamitous. Dodd and the other pioneers lived in the X-ray.”
John L. Bauer was the first victim of the X-ray, in 1906. He was
followed in 1914 by Henry Green, who, although he knew he was doomed,
and in spite of the fact that he had become almost helpless physically
because so much flesh had been cut away in amputating cancerous
growths, persisted in his work to the end.
Major Eugene Wilson Caldwell of the Medical Reserve Corps of the United
States Army, the inventor of the Caldwell liquid interrupter and
other devices for therapeutic use, lost his life in 1918. Dr. Charles
Infroit of the Salpetrière Hospital, Paris, died on November 29, 1920.
One of Dr. Infroit’s hands became infected in 1898 as a result of his
continuous use of the X-ray, and an operation was performed. After that
he had 24 other operations, 22 of them performed in the last ten years
of his life, the last on August 1, 1920, when his right arm and left
wrist were amputated.
Dr. Charles Vaillant, whose heroic services to humanity have made
necessary 13 amputations until now he is armless, on February 19,
1923, received from United States Ambassador Herrick the Carnegie
plaque, while the cravat of the Paris Gold Medal of the French Legion
of Honor was conferred upon the martyr. Physicians say further
amputations are inevitable, and that these will result in Vaillant’s
death.
In 1921, the eminent English radiologists, Dr. Cecil Lyster and Dr.
Ironside Bruce, and Dr. Adolphe Leroy of the St. Antonie Hospital in
Paris, died martyrs to their noble profession. “All of these men went
knowingly to death. Perhaps they did not take their sacrifices in the
spirit of the saint, possessed by a vision of suffering humanity.
Theirs may have been the ardor of the scientist, the endurance of a
worker who hears the challenge of nature’s silence and goes to battle.
But in themselves they express the powerful urge of a spirit that longs
to see, to feel, to know, and to possess all the mysteries of the
universe. It is the same spirit that makes men rebel and agonize for
a better order of humanity. These men seem better than the world that
produces them. But each of them, when he dies, may pull the rest of
humanity a little closer to his level.”
Dr. Frederick Henry Baetjer of Johns Hopkins Hospital has only two of
his ten fingers left. He lost the other eight as the result of burns
received in X-ray experimentation.
Dr. Francis Carter Wood, X-Ray and radium expert of the Crocker Special
Fund Cancer Laboratory of New York, calls particular attention to
the fact that “the deaths which are occurring now are the results of
repeated exposures ten or more years ago, when no one knew what the
effect of the rays might be. The burns suffered then were the result of
continuous exposure without protection against the rays. One exposure,
or a moderate number of them, would do no harm; but before the present
perfection of the apparatus it was necessary to adjust the focus for
each picture, and the operator would do this by looking at his bare
hands through the fluoroscope. This resulted in chronic burns, and the
burned flesh formed a fertile soil for cancer. Lead one-quarter of an
inch thick will stop both radium and X-rays.”
In Dr. Wood’s opinion, workers in X-rays today “need not suffer any ill
effects except through their own carelessness.”
A discovery which promises to put an end to the dangers to life and
limb risked by those who engage in working with X-rays was communicated
to the Academy of Sciences of Paris as early as May, 1920. It is the
result of experiments by Dr. Pesch of the Faculty of Montpelier, who
himself is one of the sufferers from X-rays, and who has long been
seeking the means of protecting his young confrères.
He found that deep red rays are antagonistic to the ultra-violet
rays which produce irritation and burning of the skin, and certain
oxidations. Thus, by the simultaneous application of both rays he
secures immunity for X-ray workers. He has already proved that erythema
can be prevented by the application of red rays. Daniel Berthelot, who
announced the discovery to the Academy, recalled that as long ago as
1872 the antagonism of extreme rays of the spectrum had been foreseen
by Becquerel in his study of phosphorescence.
Dr. Pesch employs a filter composed of a plastic material that allows
only the red and yellow rays to pass. It is claimed that by means of
this filter not only are the X-rays made harmless, but its employment
effects a cure for radio-dermatitis, the affection which has maimed or
killed so many of the early workers in X-ray therapy.
According to Dr. G. Contremoulins, Chief of the principal laboratory
of the Paris hospitals, whose researches and experiments were begun
in February, 1896, the usual methods of protection even today are not
always adequate. Says he (in _La Démocratie Nouvelle_, Paris, April,
1921):
“Young radiologists, especially those born of the war, take no heed
of the experience acquired by their elders, being quite convinced
that the glasses, gloves and aprons containing lead offer a perfect
protection—they even imagine that strictly speaking they might get
along without them.
“Like a child which hides behind a wooden door to shield itself from
the bullets of a machine gun, our young radiologists believe they are
safe when they have donned their gloves and examine their patients
behind a sheet of lead glass. But, unfortunately, these enable them
only to avoid those superficial skin affections caused by the most
absorbable rays of the spectrum.
“But they receive, alas, those other radiations which are more
penetrating, and these slowly produce lesions of all the ductless
glands in the body, whose internal secretions we now know to be of such
vital importance in the bodily economy.”
The modern employment of 200,000 volts under three milliamperes gives
rise to the need of great caution in the use of X-rays. Even the
health of persons in adjoining rooms or buildings, Dr. Contremoulins
believes may be imperiled. In the _Popular Science Monthly_ for
October, 1921, this veteran radiologist makes some startling
revelations. To quote a few passages:
“In April, 1896, five months after the discovery of X-rays—or Roentgen
rays, as they are also named in honor of their discoverer—a pose of
eight hours was required for a correct radiograph of a profile head,
the tube being placed ten inches from the sensitive plate.
“In April, 1921, a similar image was obtained in four hours at a
distance of 90 yards from the apparatus. This means that the radiation
with modern apparatus is more than 20,000 times stronger than was
possible in 1896.
“With the very weak radiation that I have used for my experiments,
corresponding to the ordinary radiographic and radioscopic work, it has
been easy for me to obtain images of metallic objects and human bones
placed on a sensitive plate 15 feet from the radiating source, although
the rays pass directly through a slab of marble an inch thick, a sheet
of lead one-tenth of an inch thick, and a flooring eight inches deep,
built of oak boards and rough plaster.
“Fifty feet from this same source I have been able in four hours to fog
a photographic plate placed behind a wall of brick and stone 20 inches
thick. Also in the same time I have obtained a correct radiograph
of a skull and a crab, 262 feet from the X-ray machine. All these
experiments were made with a 17-centimeter spark and two milliamperes
of current.
“If photographic plates are so readily affected by these rays, we must
admit that animal cells also are affected to an appreciable degree.
The X-rays that are being used to cure a patient may at the same time
inflict radio-dermatitis on other persons exposed to their influence in
adjoining rooms or buildings. Nothing will suffice for safety but to
cover the walls and floors of X-ray rooms with sheets of lead from a
quarter to half an inch thick, according to the power of the source and
its distance from the lining....
“Biologic reactions from X-rays take two forms. The first is a skin
lesion known as radio-dermatitis, caused by the skin’s absorbing a
large quantity of radiations. The second results from the improvements
in X-ray tubes and the use of filters absorbing the radiations of
long wave length, currently named ‘soft radiation.’ This reaction
takes place deep beneath the skin upon the active cells that are the
most vulnerable. It is principally the internal secretion glands that
are affected. Among those who continually receive even weak doses,
a gradual lessening of vitality takes place, leading slowly to a
physiological impoverishment that inevitably carries them off sooner or
later.”
Dr. Contremoulins was able to escape serious injury up to the outbreak
of the World War, but is now a victim of his services to wounded
soldiers. As a result of his efforts—and due also, partly, to suits
brought against a Paris physician by neighbors who alleged that their
health had been impaired, resulting (perhaps) in two cases of cancer—a
thorough-going investigation was undertaken by the French Ministry of
Hygiene.
Dr. Declere of the Academy of Medicine presided over a committee which
included Mme. Curie, M. Becquerel, a radiologist; Dr. Vaillant and a
number of specialists. A leading member of the Academy said he did
not believe that X-rays menaced persons who did not come into direct
contact with them.
“I intend to study the question by three methods,” he said. “First, we
shall make a purely physical examination, studying the action of the
rays and in what measure they exert themselves at certain distances.
Second, we shall experiment with the living tissues of rabbits, trying
various distances several hours a day and noting the effect on the
red and white corpuscles and glands of the animals. Then, since it
is impossible to make such experiments on human bodies, we shall
collect data based on 25 years’ experience with X-rays to see whether
physicians in close contact have been burned.”
While X-ray treatment cannot be said to _cure_ a deep-seated cancer,
it is undoubtedly being given with highly beneficial results in many
cases, alleviating much suffering and retarding the growth of malignant
tissues.
As is well known, tuberculosis can advance to a dangerous stage before
it exhibits physical symptoms recognizable by physicians. The X-ray
not only brings to light incipient consumption, but reveals the exact
place and extent of the lesion. Any abnormalities of the alimentary
tract, also, may readily be brought to view, as well as certain effects
produced on certain arteries, due to arterio-sclerosis or to angina
pectoris (a very painful form of heart disease).
It has been well said that “the list of diseases, the presence and
extent of which are betrayed or confirmed by the X-ray, would fill
pages and would include most of the enemies to human health. Among them
may be mentioned many forms of tuberculosis, occult abscesses whose
ramifying consequences physicians were once unable to refer to their
source, tumors, cancers, kidney stones, gastric ulcers, diseases of the
heart.”
The martyrdom of radiologists has not been in vain.
In cases of emergency, X-ray diagnosis may now be given patients in
their own homes. A surgical X-ray outfit that can be carried in an
ambulance and taken to the bedside of a patient too ill for removal
to a hospital passed a successful trial in England, thus adapting an
emergency war-time arrangement to civilian use. A generator in the
ambulance operates the tube, which has a special mounting that enables
it to be placed over the patient’s bed, and adjusted for height and
position by hand-wheels. The control apparatus is mounted on a separate
stand, and connected with the ambulance outside by a cable wound on a
reel. Provision is made for developing the exposed plates at once, so
that a diagnosis can be made in a few minutes.