X-ray, violet ray, and other rays

by Maynard Shipley

X-RAYS FOR MALARIA

An Italian physician, Dr. Antonio Pais, of Venice, has since 1916 been successfully treating malaria by means of X-rays. This treatment is, however, not employed as a substitute for quinine, but merely to reinforce its action. The X-rays are directed toward the region of the spleen, and the effect is to reduce its enlargement. At the same time the composition of the blood is modified. The success obtained by Dr. Pais has, according to the Bibliothèque Universelle et Révue Suisse (Lausanne), been so great that the Italian Government decided to introduce his method of treatment into the military hospitals.

Since the war the treatment has been studied by Prof. B. Grassi, who made a report, at an Italian scientific meeting, in which he declared the action of X-rays upon chronic malaria to be “truly marvelous.” The Bibliothèque Universelle says, regarding earlier treatments:

“The attempt was made by them to destroy the parasite contained in the spleen. But it is now known that the X-rays employed for therapeutic action have no effect upon micro-organisms, although they may be injurious to the elements of the blood. In the method devised by Dr. Pais, the X-rays are employed to stimulate the functioning of the spleen, of the marrow, and of the lympathic elements by means of slight but prolonged excitation; they are employed in infinitesimal doses—homeopathically, so to speak. Thus the result is absolutely different as well as the method.”

Dr. James B. Murphy demonstrated that accompanying cancer grafts on immune animals there occurs a general increase in the circulating lymphocytes and hyperplasia of the lymphoid tissue. When the lymphoid tissue of immune animals was destroyed, the immunibility was annulled. Two methods of increasing the lymphocytes have been found, namely, diffuse small doses of X-rays, and dry heat. Mice with lymphocytosis induced by these agents show Increased resistance to replants of their own tumors. The results afford ground for hope of human application. (Reported in Scientific American Monthly, January, 1920, page 96.)

It has been found that actively growing tissue, whether normal or pathological, is the most susceptible to X-rays, and it is comparatively easy to sterilize a number of species of animals without otherwise injuring them. (Prof. James W. Mayor, Science, September 23, 1921.) C. R. Bardeen found that X-rays prevent worms from regenerating lost parts. Observations of the effect of exposure to X-rays on the fertility of animals were described in a paper by Prof. L. H. Snyder of the North Carolina College of Agriculture. Exposure of male rats to X-rays, he said, had rendered them sterile at the end of two months, the animals regaining fertility when no longer subjected to the rays.

If not handled with due caution and skill, X-rays may do more harm than good, provoking malignant growths as well as retarding their development. As early as 1911, Otto Heese published a record of 54 cases of cancer caused by means of improper handling of these powerful rays.

In the early days of X-ray therapy the nature and effects of these radiations were wholly unknown. Operators did not hesitate to test and adjust their tubes by throwing the shadow of their hands on the flouroscope. X-rays do not make objects visible to the human eye, and to see the effects of them it is necessary to interpose a special screen between the eyes and object through which the X-rays are to penetrate. The cardboard screen is coated with a fluorescent substance, such as barium-platinum-cyanide, or calcium tungstate. This screen is best placed in one end of a black wooden or pasteboard box, against the other end of which the eyes are placed when in use.

This screen under the influence of X-rays becomes luminous and enables one to see shadows or silhouettes of objects of denser material interposed between the eyes and the X-ray tube, when the tube is in operation.

CHAPTER III
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.

CHAPTER IV
DISCOVERY AND NATURE OF X-RAYS

In March, 1923, there passed from this world one of the most beautiful exemplars of the true scientific spirit that earth has ever seen—Dr. William Conrad Roentgen, F.R.S., Professor of Experimental Physics in the University of Munich, the discoverer of X- or Roentgen Rays.

Born at Lennep, on March 27, 1845, Professor Roentgen filled a number of important posts before his death in 1923, in which year he was awarded the Nobel Prize in Physics—an award which brought with it a gift of $40,000. Although suffering from the poverty which resulted in Germany as an aftermath of the World War, Professor Roentgen refused to utilize the Nobel Prize award for his own personal uses. He gave the entire sum to a research society to enable other students to carry on their investigations.

While occupying the chair of Professor of Physics and Director of the Physical Institute at Würzburg, Dr. Roentgen made the discovery—in 1895—for which his name is chiefly known—though his researches led to important advances in several other departments of physics.

While experimenting with a highly exhausted vacuum tube on the conductivity of electricity through gases, Dr. Roentgen noticed that a paper screen covered with potassium platinocyanide—a phosphorescent substance—which chanced to be lying nearby, became fluorescent under action of some radiation emitted from the tube, which at the time was enclosed in a box of black cardboard. Professor Roentgen then found, by experiment, that this heretofore unknown radiation had the power to pass through various substances which are impenetrable to ordinary light-rays. He found that if a thick piece of metal—a coin, for example,—were placed between the tube and a plate covered with the phosphorescent substances, a sharp shadow was cast upon the plate. On the other hand, thin plates of aluminum and pieces of wood cast only partial shadows.

Thus was it demonstrated that the rays which produced the phosphorescence on the glass of the vacuum tube could penetrate bodies quite opaque to ordinary light-rays. Like ordinary light, these rays affected a photographic plate; but owing to their peculiar behavior in regard to reflection and refraction, Roentgen was led to put forward the hypothesis that the rays were due to longitudinal, rather than to transverse waves in the “ether.” They will ionize gases, but they cannot be reflected, polarized or deflected by a magnetic or electric field, as are ordinary light-rays. (It has been shown that the scattered secondary rays show polarization.)

Being in doubt as to the real nature of these penetrating rays, Roentgen called them “X-rays.”

In 1896 Professor Roentgen was the recipient of the Rumford Medal of the Royal Society. This honor was shared by his compatriot Philipp Lenard. Lenard was the discoverer of the rays emanating from the outer surface of a plate composed of (any) material permeable by cathode rays. By impinging on solids, the cathode rays (negative electrons) generate X-rays. “Lenard rays,” which are similar in all their known properties to cathode rays projected from the cathode of a vacuum tube, do not emanate from the cathode. (Unlike the X-rays, cathode rays may be deflected from their natural course along “straight lines” by the application of a magnetic or electric field.) Professor Lenard, as also Hertz, discoverer of the now well-known “wireless waves,” had already demonstrated that a portion of the cathode rays could pass through a thin film of a metal such as aluminum.

When Roentgen rays (X-rays) are allowed to fall upon any substance, the matter emits cathodic (or secondary Roentgen) rays. “The characteristic secondary radiation may be compared with the phosphorescence produced by ultra-violet light, and the cathodic secondary rays with the photoelectric effect” (Sir J. J. Thomson).[2]

The penetrating power (“hardness”) of these rays appears to be determined solely by the nature of the elements in the emitting substance. The velocity of the cathodic (or secondary Roentgen) rays seems to be quite independent of the matter exposed to the primary rays, but increases as the hardness (penetrating power) of the primary Roentgen rays increases.

The character of the emitted rays, in brief, appears to be quite unaffected by the chemical or physical condition of the element. Red-hot iron, for example, exhibits the same characteristic Roentgen radiation as iron at room temperature. But the penetrating power (hardness) of this characteristic (emitting) radiation increases gradually and continuously with increasing atomic weight of the emitting elements. The complete independence of the penetrating power of the characteristic Roentgen radiation from external surroundings indicates strongly that it is closely connected with the nature of the nuclei (“cores”) of the atoms giving rise to it.