Volume 1

A system of medicine by eminent authorities in Great Britain, the United States and the Continent / edited by William Osler, assisted by Thomas McCrae.

Date:
1907-10
Catalogue details

Licence: In copyright

Credit: A system of medicine by eminent authorities in Great Britain, the United States and the Continent / edited by William Osler, assisted by Thomas McCrae. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    85/986 (page 61)
    I.inscr have shown tliat .e-rays attack first the bloodvessels and esj)ecially their intiiua; all other phenomena are secondary to this ett’ect. Milehner and Mosse described changes in the bone-marrow; Birch-Hirschfeld observed optic atrophy after exposure to .r-rays. Symptoms of paralysis in small animals have also been noticed by some investigators, showing involvement of the nervous system. Whether in the latter case there were real pathological changes or only a dynamic disturbance, it is difficult as yet to tell. At all events the effect of .r-rays on internal organs became an acquisition of science, and facts began to accumulate. Among these the most interesting and important are those concerning the effect of Ront- gen’s rays on the generative organs. Albers-Schonberg^ was the first to observe that .T-rays produced steril- ity in rabbits and guinea-pigs without any change in the sexual potency. Death of spermatozoa was the immediate cause. Azoospermia and atrophy of the testicles followed. The experiments consisted of daily exposuresfor 15to30 minutes, and about 195 to 377 minutes were necessary to produce the desired results. According to Frieben,^ the reason of the azoospermia lies in the disappearance of the epithelium of the seminal canals, which leads to atrophy of the testicles. Seldin verified and corrob- orated in all its details the discovery of Albers-Schdnberg and Frieben’s e.xplanation of the azoospermia. A year later Buschke presented at the International Congress of Dermatology macroscopical and microscopical specimens of testicles atrophied from «-ray exposure. Philipp reports similar observations made in man. His first patient was a man of twenty- five with personal and family histories of advanced tuberculosis. In order to avoid an increase in his family, he accepted willingly the proposition to undergo an exposure of his testicles to x-rays with the distinct purpose of bringing on sterility. For thirty days he had a daily sitting of ten to fifteen minutes’ duration. During the treatment the sperm was examined every eight days. Five examinations were made, and all gave the same result: normal spermatozoa without the slightest change in size, number, or form. No trace of nuclear degeneration or pigmentation was noticed. A sixth specimen was obtained from the patient and exposed directly to the effect of the .x-rays, but without the slightest result. After the failure of this method the patient had a bilateral resection of the spermatic ducts done. As according to Albers-Schonberg at the end of six months an atrophy develops gradually in the testicles, Philipp extracted directly from the testicle with a hypodermic needle a few drops of semen. The micro- scopical examination confirmed entirely Albers-Schonbcrg’s andSeldin’s views: po trace of spermatozoa could be found. The testicles diminished in size, but the sexual power remained normal. In another case a man of thirty-one suffered from intertrigo with jwuritus ani. A-ray exposure over the perineum was proposed. A daily exposure for ten minutes, and altogether 195 minutes, cured the patient from the intertrigo and ]wuritus ani. Seven months later a small ciuantity of sperm was examined and no trace of spermatozoa wa.s found. Very recently F. Tilden Brown reported his observations concerning the sexual condition of physicians and patients who have been exposed to the x-rays. lie announced at the .January meeting of the New York ^Miinch. Med. Wochenschr., 190.3, No. 43. ?Munch. Med. Wocherv^chr., 1903.