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.

    87/986 (page 63)
    It is their direct action that causes the lesions described above. Accord- ing to Scholz, the x-rays have a specific action on the elements of the skin, causing a slow degeneration of the cells of epidermis, hair-follicles, glands, and also of the connective-tissue cells of the corium; the nu- cleus is affected by the degenerative process as well as the protoplasm of the cell. As to the question whether the .x-rays have only a local or a general effect on all the tissues through which tliey pass, the concensus of opinion is that the first effect is on the skin; the deeper tissues, as muscles and bones, are influenced only slightly. If necrosis follows, it is only secondary to a pronounced inflammation and ulceration. Curiously enough, they affect not only the skin at the point of their penetration, but also at the level of their exit. Revillet and Kiimmel have shown that illumination of the thorax produced an erythema on the thorax and back. As to the intermediate organs the effect is usually little or none whatever. This observ'ation is also in accordance with clinical experience. Treatment.—^There is no special treatment for x-ray accidents. As the superficial lesions are similar to those produced by the violet rays o!f the spectrum. Bar’s suggestion as to the use of red light, which is proven to be antagonistic to the violet, is certainly very interesting. He at least obtained very encouraging results. On the other hand, Kaiser reported recently that blue light-rays gave him good results. Pain may be re- lieved by static electricity, according to d’Apostoli. High-frequency cur- rents have been also suggested for x-ray burns. As to local applications to the diseased tissues, various drugs have been recommended, but none has any specific value. Nitrate of silver (2 per cent.), picric acid per cent.), zinc ointment, cocaine (for pain), peroxide (in cases of exudation and suppuration), pyoktanin (3 per cent.), and others, are all remedies which are advised in x-ray burns; but they have been used in burns of any other origin. It is well, however, to remember that the effect of the drugs just mentioned is not as prompt as in ordinary burns. A few hints concerning special features of the action of x-rays will aid in forming an idea of ]>rophylactic measures. Daily radiation has a cumu- lative effect. Various parts of the body are differently affected. Parts covered with hair (head and chin), the nails, and bloodvessels, are more predisposed to inflammatory dermatitis than any other portion. A dis- eased skin is much more easily penetrated by .x-rays than a healthy skin. According to Scholz the more rays emanate from the tube, the stronger is the effect on the skin. He also advises the use of soft tubes for therapeutic purposes instead of hard ones, as from the latter emanate few .x-rays, but there is much electrical discharge. Ivarge doses, prolonged exposures, and proximity of the tube, are capable of devitalizing tissue-elements and causing their degeneration. An important point to remember concerning the administration of x-rays is the danger of disseminating the malignant process in cases of neoplasms, or of causing a more rapid growth. OTHER RAYS. Becquerers discovery of rays given off by uranium (pitchblende) or its .salts led to the discovery of radium and polonium, by M. and Mmc. Curie; also of actinium (Debicnne), of rays N and N' (Blondlot