Roentgen Treatment of Bronchial Asthma

Abstract

We realize that statistical studies of the results of the roentgen treatment of asthma are of only questionable value and that they may be misleading because of the multiple etiologic factors. We admit, also, that almost any kind of treatment, even a minor change in the usual medication or the use of a new proprietary remedy, may be effective in a certain number of patients. In the cases which we shall consider, roentgen therapy was used only after specific or non-specific therapy had failed to produce relief or after a specific cause for the asthmatic attacks could not be found. Most of our cases belong to the latter group. Some of the patients were known to be sensitive but failed to obtain relief by specific treatment. It has been our practice to employ some type of treatment other than roentgen therapy in almost all cases of asthma, but in a few instances irradiation has been used alone. No mild cases of asthma were treated with roentgen rays. About half of the patients had severe or very severe asthma; in the remainder the condition was moderately severe. The two groups constitute about 6 per cent of the total number of asthmatic patients who have been treated at the Mayo Clinic. The use of roentgen rays in the treatment of asthma is by no means new. Most investigators have reported beneficial effects from such treatment. Various regions of the body have been irradiated, as the spleen, suprarenal glands, liver, thorax, long bones, and pituitary body, all with comparable results. In fact, some writers have “treated” patients without the roentgen tube being in operation at all and have obtained benefit. In 1936, we reported (1) the results obtained by irradiation of the mediastinum in 23 cases of severe asthma. The patients were treated in the years 1931 to 1934, inclusive. Five of them were improved to a great degree for many months; 8 were definitely relieved for shorter periods. In the 10 remaining cases, the results were classified as failures. In this group of cases, a technic of treatment through paravertebral fields was favored, and a dose of about 550 r was administered in two days. Roentgen rays generated at 135 kv. and filtered through 6 mm. of aluminum were employed. The conceptions on which this treatment was based were as empiric and as indefinite as was our knowledge of the true nature of asthma, but in general the method seemed to produce better results than other methods which we had been using, such as irradiation of the spleen, of an anterior mediastinal field, or of a combination of different fields. The technic had the additional advantage of producing fewer gastro-intestinal upsets than did the methods previously employed, and, as we have said, it seemed to produce an appreciable relief from the asthma. In 1939, we reported (2) another series of 215 cases treated in the years 1935 to 1937, inclusive. One hundred and sixtyone of these cases were available for statistical analysis.