The phonoscope (Nov 1896-Dec 1899)

Vol. I. No. 6 THE PHONOSCOPE 15 Causes of J=ra£ Burns Danger Comes From Lack of Skill, says Dr. W. J. florton The occurrence of burning by the ROntgen rays has become so frequent as to be a matter for serious consideration from a physiological point of view, besides threatening to interfere with the general utility of the rays in various scientific and industrial fields. In one case reported, a piece of burned flesh as large as the fist had to be cut away from a sufferer, and in others the wounds were intensely painful, and resisted, sometimes for months, everj' attempt to heal them. The seriousness of this burning may be judged from the fact that the inflammation caused by the Rontgen rays on human flesh is a true gangrene, or death of the cells. With a view to throwing light on this subject which seems to be little understood, an interview with Dr. William J. Morton, who has been described by Edison as "the first X-ray expert in America." Dr. Morton said: 'T have read with a great deal of solicitude the various accounts of burns and injuries by the Xray, for I see that what promised to be, and what surely is, one of the most valuable aids to surgery, in the way of diagnosis, yet discovered, may suffer irreparable harm from these accidents. Were there the slightest necessity for accepting this reflection on a magnificent modern achievement, one could bear it with more complacency; but since such is not the case, we must do all we can to enlighten the public as to the true facts. The truth of the matter, sad as it is to relate and stating the case most mildly, is that the burns of which there have been so many serious and even shocking cases have been produced by inefficiency either of the apparatus or of the operator. No subject of such complexity as the expert management of the X-ray can be mastered by Tom, Dick, and Harry without adequate prior study and practice. In most scientific pursuits a preliminary technical institution training is required, especially in such as relate to electricity and the physical sciences in general. In the case of the X-ray, a double preliminary training is essential, namely, both that of the electrical expert and that of the physician. It would now seem that every lineman deems himself more that capable of performing medical service through the medium of X-ray pictures for such clients as may choose to come to him. "As a matter of fact, without wishing to call attention to my own share in the use of the X-ray in surgery, I may say that of the nearly 500 X-ray pictures I have already taken, and in the course of continued experimentation with Crookes tubes, I have never yet seen or experienced the slightest burn or injury to a tissue, not even have I discovered the slightest irritation of the skin, even in the most sensitive subjects. The only exception I can make to this statement is that I early remarked the fact that after several hours' use of the fluoroscope and experimenting in the atmosphere of the rays, I have on frequent occasions noted in my own person an irritation of the eyelids, namely, an itchings burning, and smarting sensation, which has alway, passed off in a few days. In the course of my Rontgen ray work, I have often taken the entire trunk, and, indeed, the entire adult body, which presupposes very powerful rays. My immunity from accidents I believe to be due, to a great extent, to the fact that I have, in the first place, possessed apparatus fully adequate to the requirements of my work, and, in the second place, I have for that reason been able to place my Crookes tubes at a veryconsiderable distance from the subject, I habitually take a hand at from two or three feet distance and sometimes four feet, and in from two seconds to two minutes. The picture of the trunk I take at a distance of from two to three feet, and in no case do I ever place the Crookes tube nearer to the subject than eighteen inches. Obviously, with weak apparatus, and more so with strong, the inexperienced man, in his anxiety to be sure to get a result, might place the tube anywhere within, say, six inches from the patient, and would undoubtedly, in a certain percentage of cases, irritate and burn the skin. A careful investigation of the reports of cases of burns thus far has satisfied me that in every instance the tube has been placed within six inches of the skin, and with a long-continued exposure, ranging often up to an hour and a half. For my part, at the distance I have mentioned, namely, an average of from two to three feet, I consider fifteen minutes' exposure amply sufficient in the most difficult cases. I remember seeing not long ago in a hospital a terrible case of ulceration of the skin. The patient, a young lady, informed me that the tube had been placed within 1 y2 inches, and that the exposure had been 1 yz hours. "The whole question simply resolves itself into this: That difficult subjects require expert management, and although it may not be true, as has been said, that an X-ray expert must be born so, still it is true such an expert must be educated up to the point of expertness. As it is now, too many would-be operators are fumbling in the dark, and the public has to pay the penalty." ' 'The amount of experimentation that has been done with the X-ray in this country is nothing short of wonderful," said T. Commerford Martin, editor of the Electrical Engineer. "Crookes tubes, which at first were scarce and cost $20 or $30 a piece, are now almost as cheap and plentiful as incandescent lamps, and people have learned to handle them so that they do not, as they did formerly, break down permanently after a few seconds' use. Some tubes in use by friends of mine have done good service for weeks and months, owing both to improvement in manufacture and dexterity in the manipulation. It is perfectly true, however, that serious troubles have arisen from what is now known popularly as 'X-ray burn.' I do not look upon this as a bad thing at all, in the broad sense, because it will teach people that experts are needed whenever it is a question of experimenting with the human body. We do not allow the free application of drugs, anaesthetics or the knife, and there is absolutely no reason why the X-ray, which, as a subtle electrical phenomenon, is one of the greatest aids that surgery and physiological diagnosis have gained in recent years, should be applied haphazard by every venturesome tyro. As a matter of fact, in view of the immense range of inanimate objects to which the X-ray can be applied, there is absolutely no reason or excuse for turning it upon poor suffering humanity, except solely with a certainty of aiding the physician in his work. ' 'I have been not a little surprised at the lateness of the alarm shown about the injurious effect of the X-ray on living tissue. At my very first interview with Mr. Edison on the subject, within a few days after the announcement of Rontgen's great discovery, he said to me: " 'Why, Martin, one of the funniest features about this blamed thing is the effect that it has upon your eyes and your skin. I am so nervous about it that I don't like to keep my eyes under its influence long. At first I thought it was the strain of staring incessantly and shut my eyes, but it didn't make any difference. My men here in the laboratory have also reported some very curious effects, the nature of which would perhaps better be reported to a doctor's meeting. I can say this, however, that we soon found out that the best way of giving a cut or a sore a chance to heal was to keep it out of range of the rays.' "Mr. Edison went on to describe various other curious physiological phenomena, and his mind at that time was really more intent on them than on other conditions to which he was paying attention. I might mention, also, that experimenting with Dr. Morton at the very beginning of the work, that expert was very anxious to know my sensations in the eyes and on the skin when subjected to the X-rays, and I fancy both Mr. Edison and Dr. Morton early discovered the correct modus operandi Tor avoiding the deleterious and apparently poisonous effect of the ray, as I don't know of a single case reported in which the experiments of either of them have resulted badly. The same is true of the work of Prof. Elihu Thomson, except that he deliberately tried to induce on his own hand the worst burning effects in order that he might find out to what they were exactly due." — TV. Y. Sun. Spoiling Slot Machines Somebody Filling Them With But= tons, Washers and Paper Wads The agents in charge of the slot machines in New Haven, Conn. — phonographs, kinetoscopes, weighing-machines, etc. — have had a great deal of trouble lately in trying to keep them in working order. Urgent calls have frequently come to them from proprietors of places where the machines are in use, with complaints that the machanism is' useless. In nearly every case the agents have found, when the machine was opened, that the interior had been choked with wads of paper, buttons, leather washers, paper disces and imitation or mutilated, twisted coins. They have come to the conclusion that somebody is making it his business to try to put every machine in the city out of order. The machines are owned by companies with headquarters in New York, and agents make regular trips to take away the money that they gather, and renew supplies in the machines that sell goods automatically. A share, generally about 20 per cent., is given to the owners of the stores where the machines are placed. These automatic machines take in a wonderfully large amount of money, and the owners do not generally lose much when they become plugged for the machines have a habit of gathering in the coin first and refusing afterward to perform the expected service. It is only when the deceived customer complains that they know anything about the trouble, so the man or boy that forces paper or other articles into the slots is really defrauding others than the proprietors. After several days of futile discussion over disputed places in the Memorial Day Chicago road race, the referee has announced that he will waive a final decision until he can view the pictures taken by a kinetoscope, which was stationed at the fiinishing point. Theoretically this would seem to afford an immediate solution of the difficulty, but the task will probably be far more stupendous than the referee bargained for, as the camera was adjusted at an angle, and the numbers on the contestants'backs will hardlybe distinguishable. Claimants who expect vindication by the photographic films will probably be requested to bring forth the costumes worn by them in the race. It has become proverbial that a cycling referee's position is an unenviable one at the best, but this particular gentleman has troubles which render the berth of the average referee one lined with roses and mounted with gold.