250

The Race to Give X-ray Vision to Medicine

by
Scope Correspondent
If you asked a radiologist which American first applied the use of X rays in medicine, his answer would depend on his loyalty, whether it is to Dartmouth, Yale, or perhaps even MIT. However, the radiologist would have to concede that X rays themselves were discovered in Germany.

Late Friday, November 8, 1895, the physicist Wilhelm Conrad Röntgen had his moment of inspiration in a University of Würzburg laboratory. He was tinkering, as geniuses do, with a Crookes tube, a glass tube enclosing a low pressure gas. After covering the tube, he placed a barium platinocyanide plate on the one side he had left open. He then applied an electric current through the tube. Röntgen noticed that the plate fluoresced, a clue that something was emanating from within the tube. He eventually called them X rays in his famous December 28 publication. For this work, Röntgen was awarded in 1901 the very first Nobel Prize in Physics.

Röntgen had in a way invented a telescope, but he didn’t realize the galaxies that resided ahead. Using X rays in clinical diagnosis, bequeathing a new sight to medicine, was for someone else to achieve.

Dartmouth College is traditionally credited for developing the clinical X ray. On February 3, 1986, Frank Austin, a physics assistant at Dartmouth urged two brothers to use X rays in treating a schoolboy’s broken wrist. Dr. Gilman Frost, a Dartmouth physician, and Edwin Frost, a Dartmouth physicist, were forever memorialized for treating little Eddie McCarthy. Their account was published soon after in Science on February 14. In that same issue, suggestions on the potential for clinical X rays were made by Michael Pupin of Columbia University and Arthur Goodspeed of the University of Pennsylvania.

Yale, though, claims it preempted these early efforts by several days. According to the university, Arthur W. Wright, a Yale physicist, made the first X-ray photograph on January 27. The very history of the Yale School of Medicine’s radiology department begins with this attempt, only a month after X rays were first reported.

But others were hot on the heels of both Dartmouth and Yale. MIT, too, had a hand in developing the clinical X ray, under the guidance of Francis Henry Williams.

Francis Henry Williams  MIT class picture

Francis Henry Williams
MIT class picture

Williams was a Massachusetts native, but also a man of international pursuits. After graduating with a degree in chemistry from MIT in 1873, he traveled to Japan to observe a solar transit by Venus, followed by a world tour. He returned and in 1877 earned his medical degree from Harvard Medical School, like others in his family. He then trained in Vienna and Paris.

Williams practiced at Boston City Hospital (what is now Boston Medical Center) and served as a professor at Harvard Medical School. He became a life member of the MIT Corporation and eventually served as president of the Alumni Association. In short, he was well connected.

Word of Röntgen’s new rays made it to America through transatlantic cable communication. The Boston Globe reported the discovery in early January 1896. Williams was quick to recognize the potential of X rays and made use of his access to MIT to begin some experiments.

He was allowed to take patients to MIT’s Rogers Laboratory of Physics, where early attempts at designing X-ray machines were already underway. This laboratory served as the location of Williams’ first attempts at diagnosing using X rays. With the assistance of MIT physics professors, Ralph R. Lawrence and Charles L. Norton, Williams performed fluoroscopy, or real-time X-ray imaging, on patients. The three collaborated on new X-ray machine designs to facilitate this work.

Later, Boston City Hospital granted Williams funds and a room to continue these diagnoses, where Williams brought X-ray machines by ambulance. This would eventually become the hospital’s radiology department. Dr. William H. Rollins, a dentist, physician and Williams’ brother-in-law, helped the team design better X-ray techniques. The two also promoted safety measures at a time when scientists and physicians were openly exposing themselves to X rays and suffering skin injuries and cancer.

On February 20, 1896, an unaccredited paper was published in Boston Medical and Surgical Journal, what is now the New England Journal of Medicine. The short paper summarizes an attempt of taking an X-ray photograph of a hand and includes the image. The article only mentions that the work was done at the physics department at MIT, in conjunction with “gentlemen connected with the hospital.” The gentleman being Williams himself would be a fair guess.

Thus, only six days after the famous Frosts at Dartmouth published their work on clinical X rays, an MIT graduate did the same. It is lost in history exactly when Williams took the photograph. It might have even been before his competitors, as publication wasn’t as rapid then as it is today.

Williams went on to become the “Father of Chest Radiology.” In 1901, he published the authoritative work in radiology for decades to come, The Röentgen Rays in Medicine and Surgery, rich with 658 pages and 390 images. The pages catalogue Williams’ pioneering thoughts on diagnosing many diseases. The level of detail in these precious first pages of radiology, from how to build an X-ray machine to how to read the image, were characteristic of Williams’ meticulous nature.

Picking apart who discovered what, when is usually a difficult task. However, the application of X rays in medicine was an explosive movement, making an exact timeline near impossible. Within a year of Roentgen’s discovery, 44 books and pamphlets, and 1,044 papers on X rays were published.

X-rays were revolutionary as they gave “eyes” to medicine. As Williams famously said, “We may now look where we have previously only been able to listen.”

In future years, we may unearth more on the history of X rays and their application to medicine. Whatever the story is decided to be, we know Dr. Williams, his colleagues, and the experts in the physical sciences at MIT, advanced radiology at a pace rarely observed in scientific discovery.

Comments

0 Comments