IN studying the problem of X-ray dosage we must consider both the quality of the ray transmitted by the filter, and the quantity transmitted per unit of time. Both the quality and quantity of this transmitted ray should be expressed in fundamental terms, if possible. Quality at present is expressed in terms of penetration or wave length, the latter a property of the ray itself, an objective standard. Quantity, on the other hand, is generally expressed biologically in terms of erythema, a phenomenon which involves two variable factors, namely, the patient's reaction and the roentgenologist's interpretation of that reaction. We should seek a unit of quantity which is fundamental, determined by a property of the rays themselves, and measurable to an exact degree; to bring into accord the various ideas of roentgenologists as to the quality or quantity, or both, to be used in X-ray therapy. Such a unit has already been presented and will hereinafter be described. Physics was not a science until physicists agreed on certain definite units of length, mass, and time; chemistry was not a science until chemists began to talk in terms of atomic and molecular weights, grams, cubic centimeters, and other definite units; units which mean the same thing to all chemists and to all physicists. The physician in writing out a prescription states so many minims, drams, grams, or ounces of a drug, or so many c.c. of a solution of a definite concentration. Not that any two physicians will necessarily prescribe the same amounts or the same drugs, but the drug and the amount are both in definite terms which allow of only one interpretation. What, then, is the condition in the X-ray field? One roentgenologist states that he uses so many milliampere minutes, at so many kilovolts, using a certain filter, and skin target distance to obtain a so-called erythema dose. But like numbers of milliampere minutes do not mean the same amount of X-ray energy with different machines, no two men agreeing on what constitutes an erythema dose. In general, equal amounts of filtered radiation will not produce a similar erythematous reaction on different patients, so that to define the amount of X-rays used, entirely by its biological effect, is very unsatisfactory. When you order an electric light bulb you are not primarily interested in the number of watts of power consumed in that bulb, but in the candle power coming from it. The old carbon filament and the newer Mazda may consume the same number of watts, but there is no doubt about which one gives the most light. Similarly, in X-rays we should not rate our tubes and apparatus by input, but by output and in terms of an X-ray candle power. As in the visible light, we cannot say that a red light is three times as strong as a blue one, but can only speak of relative intensities for two lights of the same color, so in X-rays we must first state the quality of the ray and then we can compare quantities.
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