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Radiology

It would be difficult to overstate the impact the discovery of x-rays in 1895 had on the field of medicine. The ability to peer inside tissue without cutting or destroying it transformed our understanding of living anatomy and opened a world of new possibilities in diagnostic medicine. Many hospitals and universities already owned or had access to the requisite equipment (cathode or Crookes tubes, electrical coils, photographic plates), so interested parties were able to start generating their own x-ray photographs—radiographs—immediately.1 Early radiography was fraught with dangers for both the technician and the patient. Cathode tubes were often unshielded, making long exposure to high radiation levels inevitable; the process also involved high-voltage electrical cables noxious photo-processing chemicals.2

WWI spurred major developments in radiological techniques for locating foreign bodies like bullets and shrapnel inside human tissue.4 In France, Marie Curie built and organized the first mobile radiological units for use in the field; by the end of the war, x-ray technology had become an indispensable part of battlefield medicine.5 One of Curie's compatriots on the literal frontlines of radiological innovation was Henri Coutard, who went on to become a core figure at the Radium Institute (now the Curie Institute).6 Around this time, doctors were also experimenting with using different kinds of radiation, including x-rays, to shrink tumors and treat skin diseases; work by Coutard, Antoine Béclère, and Claudius Regaud laid the foundations for oncological radiotherapy.7 Other Parisian doctors developed techniques to map blood vessels, organ systems, and other tissue structures that would not ordinarily show up clearly on radiographs. Injections of mercury and other heavy metal-based solutions could be used in cadavers, but not in live subjects. Jean-Charles Roux and Victor Balthazard achieved early successes in gastrointestinal radiography with ingestible bismuth subnitrate8, and Jean-Athanase Sicard and Jacques Forestier imaged a living patient's arteries in 1923 using Lipiodol.9

Le Tube de Crookes: Applications Médicales et Chirurgicales des Rayons de Roentgen, de la précision dans les méthodes radiographiques

Arteriographs show the blood vessels in the hand and knee of a cadaver injected with mercury, circa 1903.

Le Tube de Crookes: Applications Médicales et Chirurgicales des Rayons de Roentgen, de la précision dans les méthodes radiographiques

Radiographs of a child's hand from birth to age 11.

Le poumon rhumatoide, revue generale et discussion du concept (A propos d'un cas)

Osteoporosis in the wrists of a 53-year-old beautician with rheumatoid arthritis.

Contribution a l'étdue anatomique des artères de la moëlle dorso-lombaire

Arteriographs of the spine, mid-dissection with artery of Adamkiewicz isolated.

Localisation des Projectiles de Guerre au moyen des Rayons X (Étude de quelques procédéet en particulier du Prpéreur Marion-Danion)

The Marion-Danion Marker, a device for determining the locations of bullets inside the body based on x-rays, circa 1915.

Le Reflux Vésico-urétéral et la Dilation des Uretères

Radiograph of the kidneys, ureters, and bladder in a case of vesicoureteral reflux, circa 1921. Colloidal silver (collargol) is the contrast medium.

L’Osteo-necrose du semi-lunaire (ou maladie de Kienbock): Étude clinique et conceptions thérapeutiques nouvelles, a propos de 20 cas

Arteriograph of a hand showing signs of Kienböck’s Disease, a rare, painful condition in which tissue surrounding the small lunate bones of the wrist becomes necrotic.

Étude a long terme des remaniements chromosmiques induits au niveau des fibroblastes cutanes par les rayons x. A propos d'un cas d'irradiation accidentelle.

Chromosomal mutations in the cells of a patient accidentally over-exposed to x-rays in a diagnostic context 23 years earlier.

Traitement immunodepresseur (cyclophosphamide) suivi d’une interruption chirurgicale de grossesse chez une femme lupique au cours d’une poussee aigue de la malade: a propos d’une observation

X-rays showing a lupus patient's heart, enlarged from myocarditis, before treatment and two months after treatment with the immunosuppressive drug cyclophosphamide.

Avantages des opicifiants hydrosolubles dans l'examen radiologique du tractus oeso-gastro-intestinal

Radiograph of a patient swallowing, achieved with a hydrosoluble opacifiant, circa 1971.

Contribution a l'étude de la radiographie du foetus in utero

Fluoroscopy (continuous radiography) of fetuses in utero, circa 1932. The dangers of exposing fetuses to radiation was not yet fully understood at the time.

L'Équipement Radiologique des Hôpitaux Psychiatriques

Radiography equipment installed at l'Hôpital de Saint-Alban, circa 1939.

La Radiothérapie: son application aux affections cutanées

A radiotherapy localizing tube used in experimental treatments for skin lesions caused by lupus, circa 1904.

Notes

  1. Doby, Origins and Development of Medical Imaging, 61.
  2. Eisenberg, Radiology, 156-160; Thomas and Banerjee, History of Radiology, 11-14.
  3. Badash, "Discovery of Radioactivity," 26; Eisenberg, Radiology, 43-49.
  4. Webb, From the Watching of Shadows, 95-98, 101.
  5. Thomas and Banerjee, History of Radiology, 45-46; Eisenberg, Radiology, 50.
  6. del Regato, "In memoriam Henri Coutard, M.D. 1876-1950," 758; Oudar, "Our history."
  7. Holsti, "Development of Clinical Radiotherapy," 996-7; Androutsos, "Béclère," 170-172; Nias, "100 Years of Radiobiology," 85. Radium was usually favored for targeted radiation treatments, as small amounts of the substance could be placed quite close to surface tumors or lesions and used to apply relatively weak radiation, whereas x-rays were more difficult to direct and frequently harmed surrounding tissue. See Ilana Lowy, A Woman's Disease, 35-36. For more on radiotherapy, see also the "Cancer" section of this exhibit.
  8. Doby, Origins and Development of Medical Imaging, 68.
  9. Doby, Origins, 73-75; van Tiggelen, "Rise of Contrast-enhanced Roentgenology," 102.
  10. van Tiggelen, "Rise," 102.

Bibliography

    • Androutsos, George, M.D. “Antoine Béclère (1856-1939): founder of radiotherapy”. Journal of the Balkan Union of Oncology 7 (2002): 169-174.
    • Badash, Lawrence. “The Discovery of Radioactivity.” Physics Today 49.2 (1996): 21-26.
    • del Regato, J. A. "In Memoriam Henri Coutard, M.D. 1876-1850." Radiology 54(5) (May 1950): 758-759.
    • Doby, T. and G. Alker. Origins and Development of Medical Imaging. Southern Illinois University Press, 1997.
    • Eisenberg, Ronald L. Radiology: An Illustrated History. St. Louis : Mosby-Year Book, 1992.
    • Holsti, Lars R. "Development of Clinical Radiotherapy Since 1896." Acta Oncologica 34.8 (1995): 995-1003. DOI: 10.3109/02841869509127225.
    • Lowy, Ilana. A Woman's Disease: the history of cervical cancer. Oxford University Press, 2011.
    • Oudar, Nathalie. "Our History." Last updated 30 May 2017. Accessed 8 January 2019. https://institut-curie.org/page/our-history. 
    • Thomas, Adrian M.K. and Arpan K. Banerjee. The History of Radiology. Oxford University Press, 2013.
    • van Tiggelen, René. “The Rise of Contrast-enhanced Roentgenology: An Illustrated and Chronological Overview.” Journal of the Belgian Society of Radiology 100.1 (2016). https://www.jbsr.be/articles/1222/print/.
    • Webb, Steve. From the Watching of Shadows: The Origins of Radiological Tomography. IOP Publishing Ltd., 1990.