Reminiscences of Roentgenology During the Last War, 1917–1919

Abstract

THE unfortunate events which are taking place abroad have stimulated our national defense program to such an extent that this is perhaps an opportune time for reviewing World War number one experiences and the problems which we were forced to meet under the most difficult roentgenological conditions. It is to be regretted that “old man military roentgenology” had to be so rudely awakened after twenty-four years of peaceful slumber. This report embodies the medical experiences of St. Louis Base Hospital No. 21 (Washington University Unit) after assuming the duties of the evacuated British General Hospital No. 12, at Rouen, France. Although the conclusions were crystallized under the stress of war conditions, nevertheless the original recommendations of 1917 and 1918 may be of interest to many who may be privileged in the near future to engage in similar activities. Modified foreign body localization methods, roentgenologic procedures in the management of war-wounded, and combination floor trochoscopic and radiographic apparatus were described by me in a paper sent for publication to the A merican Journal of Roentgenology during the Christmas holidays of 1917, but this was, perhaps, lost during a period of unusually active submarine warfare and may today be deposited in Davy Jones' locker of the Atlantic. I will attempt to present these data, together with the original recommendations made in 1917 (recently resurrected from an old dust-laden army trunk) relative to the scope and limitations of the unforseen problems of a British Base Hospital. When I use the term “x-ray plates,” you will understand my reason for so doing, since films were an unknown quantity in our area. A small group of the 1,000-bed hospital units can be seen in the foreground of the accompanying photograph (Fig. 1) taken from the famous Rouen, France, racecourse grand-stand. The x-ray department was indeed fortunate in being housed in portable wooden huts (Fig. 2) instead of tents. The x-ray equipment allotted to us, however, was limited to one 6-inch “Butts” x-ray coil, Zenith mercury gas interrupter, wooden x-ray tube holder, and table. The current was supplied by eight one-inch-square celluloid wet storage batteries and these were, in turn, charged several times a day by a small one-cylinder gasoline engine. Both the gasoline engine and the Macalaster Wiggin gas x-ray tube proved to be, at times, temperamental—either the gas engine wouldn't turn over or the x-ray tube became “cranky.” The combined space of the eight small batteries was less than an average-size automobile battery of today. The full output of this apparatus, except when the x-ray tube was very “soft,” never registered beyond two milliamperes. For fluoroscopic work less than half of that amount was employed. Two milliamperes of current was the maximum output for radiographic work at 50 cm. focal plate distance, and the one-milliampere technic was limited to fluoroscopic observations.