PracticalversusTheoretical Application of High Voltage X-rays and Radium

Abstract

IN the practice of medicine, as in other arts and sciences, to some it is given to lead, to others to follow; to some is the opportunity given to map out the theoretical, technical and scientific aspects of the problem, while to others of us falls the lot of artfully adapting the dictum of theory and fact to the solution of the problems at hand, confirming such teachings or proving them impractical. The writer's energies have been directed wholly to the practical uses of radiation therapy, an effort trying, and at times discouraging, when confronted with the facts, theories and dreams which have so tended to confuse as well as clarify the situation. To unravel, assort and logically arrange these facts and theories is an Herculean task; to fit them in and demonstrate them practically is an impossibility. Hence those minds with the inherited tendency to think for themselves may be pardoned when they wander from the path laid out for them and presume to speak from their own limited experience and in language shocking to the ultra- or pseudo-scientist. When the lightning-like flashes of high-voltage electricity began to leap across our horizon a few years ago, and seemed to give promise of illuminating the darkest recesses of radiation knowledge, my mind wandered back to the year 1904, when, in the rural section of southern Louisiana, I saw my twelve-revolving-plate static machine speeding under the power of a snorting gasoline engine, and wondered if that power which shot those sparks across an air gap of 12 to 16 inches, was not the same force—only made greater and bigger and stronger in the resurrection. Such, it seems, was and is the case. And my second thought was: Does the bigness, the greatness and strength of this force solve our problems, or will there develop the greater problem of controlling, measuring and directing its energies? Again, it seems, our thought was prophetic, for it appears now we are all agreed that the methods of measuring and directing radiation intensities have done more to advance radiation therapy than has the manufacture of high-voltage X-ray machines. In the practical application of X-rays we accomplished just as satisfactory results years ago when operating with medium voltage as we have in more recent years with the higher voltages. This is but a practical proof of the scientific fact that biologic action is more proportionate to the quantity than to the quality of radiation. The practical problem has been to determine the relative quantity of radiation delivered to, and produced in, the tissues and the effects produced by these quantities on the different pathologies. The methods of measuring radiation, now familiar to us all, have partly solved this problem, and have, further, demonstrated that a given quantity can be delivered more accurately, more constantly, and more easily with high than with low voltage. This, to our mind, constitutes the one and only advantage of high voltage.