The Short Wave X-rays in other than Deep Conditions

Abstract

WHAT do we mean by deep X-ray therapy? This term is now in general use by the medical profession at large, and is being rapidly generalized to the public. How can the term, “deep therapy,” be expressed so that it will mean the same to all radiologists? To some individuals, deep therapy is associated only with conditions situated within the confines of the abdominal cavity. To others, any pathology not strictly on the skin or external surface of the body is catalogued under deep therapy. Many radiologists again associate deep therapy only with the new high voltage generators of two hundred thousand or over. Literally, deep X-ray therapy should embrace everything treated beneath the skin surface, and not be confined to any particular pathological level or location within the body. In other words, in the writers' opinion, the term is not scientific, and had better be abolished. It is, of course, possible to secure deep effects with any voltage which will generate X-rays, the effects obtained depending entirely upon filters and time elements. The term, “short wave X-rays,” is more expressive, in that it is usually considered synonymous with the operation of a high voltage generator. Yet this is also vague, in that it does not carry similar conclusions to all radiologists. It is now generally conceded that only those rays which are absorbed functionate; therefore, the problem to be solved is to use a voltage which will insure qualitative homogeneous radiation to a desired field. Another change to be desired is in the present practice of quoting electrical factors when describing dosage. The usual formula of so much spark gap, distance, and milliampere minutes, does not convey anything of value to another radiologist. It may be sufficient to the one who gives it, but in order to carry dosage to the other fellow, it must be expressed in units of an erythema dose. Your erythema dose and our erythema dose may be obtained under entirely different conditions and with different apparatus, and your electrical formula, even if followed to the letter in our laboratory, would not yield the same results. If you simply say that you have given a patient a half erythema dose with a definite filter on such a date, we will know at once how to proceed, no matter what form of measuring device you are partial to, be it electrical, iontoquantimeter, or spectroscope. The erythema dose has to be established as the basic unit by which to describe accurate dosage. With the thought that time and skin and superficial layers of healthy tissue could be saved by using short waves in conditions not considered strictly of the deep variety, such as metastatic nodes in or near the surface, hypertrophic tonsils, infections of the accessory sinuses, cervical adenitis, and many unclassified lesions more or less within the surface, we have begun operations upon such.