850

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History
.

of Radiology

. :

#{149}

:.

Early American
David J. DiSantis1

Radiology:

The Pioneer

Years

Very few American radiologists have a more-than-cursory idea of our specialtys beginning in the i 9th century. Roentgens story is widely known, but the Americans who helped lay radiologys foundations in our country remain essentially anonymous, especially to younger members of our profession. This paper chronicles the landmark years of early American radiology. Can American radiology really have celebrated its 96th anniversary when X-rays are only 90 years old? The saga begins one evening in late February i 890, in a University of Pennsylvania physics laboratory. After an experimental session testing electric sparks as a photographic light source, Professor Arthur Willis Goodspeed began demonstrating the properties of a Crookes cathode-ray tube to William Jennings, a photographer. Next to the tube, Jennings had stacked several unexposed photographic plates, on top of which were two coins, reportedly his fare for the Woodland Avenue trolley [i ]. When Jennings later developed the plates, some were mysteriously fogged, and one displayed two peculiar diskshaped shadows (Fig. i). Neither man could explain the phenomenon, and so the plates were filed and forgotten for nearly 6 years. Only after Roentgens discovery did the men recreate the setting of that February night and grasp the magnitude of the observation that they had failed to make. Although he claimed no credit for the interesting accident, Goodspeed maintained that without doubt, the first Roentgen picture was produced on February 22, i 890 . . . [at] the
University of Pennsylvania [2].

The scientific ment can hardly papers dealing

Received March
I

furor engendered by Roentgens announcebe overestimated. In the ensuing year, i 000 with X-rays appeared [1]. Americas true
21
,

introduction to radiography came in early i 896. As is often the case even now, news of a scientific breakthrough arrived first through the lay press (Fig. 2). On January 6, i 896, the Sunday New York Sun announced that Professor Routgen [sic] had discovered the light that never was, which could photograph hidden things including bones within flesh. The Roentgen fever in the European scientific community quickly became an American epidemic as well. Although the race for the first American radiograph had been won inadvertently by Goodspeed even before the starting gun, the contest for the first intentional radiograph was still on. Arthur Wright of the Yale Physics Department won, literally with a photo finish. On January 27, i 896, 80 days after the discovery of X-rays, he placed cardboard-covered photographic paper beneath a cathode-ray tube. On the paper he placed a pencil, a pair of scissors, and a quarter. Using a lengthy exposure time of 1 5 minutes, he obtained a very clear representation of the objects employed [3]. Modern publication delays were not such a problem in i 896: His success was reported in the Engineering and Mining Journal dated February i only 4 days after the event [2]. Meanwhile, in Boston, John Trowbridge, director of Harvards Jefferson Physical Laboratory, was working toward the same end. He detailed his success in the New York Journal dated February 2, appearing just i day after Wrights report. While Yale and Harvard vied for priority in the laboratory, another Ivy League institution, Dartmouth, was making clinical history. Edwin Brant Frost, a professor of astronomy, was familiar with cathode-ray tubes, and he was asked by his physician brother, G. D. Frost, to radiograph the fractured forearm of one of his patients (Fig. 3). So, on February 3,
,

1986; accepted after revision May 22, 1986. DePaul Hospital, Eastern Virginia Medical School, 150 Kingsley Ln., Norfolk, VA 23505. Address reprint requests to D. J. DiSantis. 1986 0361-803X/86/1474-0850 C American Roentgen Ray Society

Department 147:850-853,

of Radiology,
October

AJR

AJR:147,

October1986

EARLY

AMERICAN

RADIOLOGY

85i

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.

A
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PbotorsphIe
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.

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#{149}_a1 to

#{149}1

. Post-DsteI. YORK. 3. 1-A cabIe%hm to ta. luft fTO!U London ay.: Ta. noise of wsrs alarm. should z#{243}t d#{244}trs.ct attention rm th. msrv.lous triumph of science whl#{248}bIs reported from Viuz. It Is announced that Prvf. Routg,n of the Wurzburg Untversity has dIacovred a light which, for the purpose of photography, Will penetrate wood, fle.b and most other organic cut sta.nc The Pro.sor has succeeded I

NEW

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presumed

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it

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#{176}i!
Fig. 1 .-000dspeed-Jennings coin shadows. (Modtled trolley fare from Grigg radiograph
[1J.)

of 1890. Arrows

point

toward

Fig. 2.-America learns of Routgens rays. Reprinted from microfilm record of the St. Louis Post Dispatch, January 7. 1896.

In his 1 930 autobiography, Pupin claimed to have received his fluorescent screen from famed inventor Thomas Edison, who had begun investigations with X-rays quite early, in January 1 896. His role became much more conspicuous,
however, after he received a telegram on February 5, i 896.

William Randolph Hearst, publisher of the New York Journal, asked Edison if he would . . . as an especial favor to the journal, undertake to make a cathodograph of a human brain [2]. Edison accepted Hearsts challenge and on February 7, the New York Times announced that tomorrow morning Mr.
Edison powers will attempt further to demonstrate the penetrating

Fig. 3.-First

clinical radiograph
Brecher

Frost is on the left (from

and Brecher

in America, Dartmouth, 12]).

1896. Edwin Brant

i 896, Eddy McCarthys left forearm was exposed to the tube for 20 mm. His Colles fracture thus became the first clinical radiograph in America [iJ. Later that same landmark month, X-ray pioneer Michael ldvorsky Pupin publicized another milestone. A patient named Prescott Butler had been sent to him with painful shot pellets lodged in his hand. Pupin was asked to make an X-ray photograph before surgery, which he did on February i 8, 1 896. However, his method had a key difference. Rather than exposing the plate using the X-rays themselves, he placed a fluorescent screen between subject and plate and used its light to make the exposure. While controversy exists regarding Pupins claim as discoverer of image intensification [2], the clarity of the radiograph produced only 3 months after Roentgens discovery is incontrovertible (Fig. 4).

of the new light by an experiment in photographing a mans brain. Reporters flocked to the West Orange, New Jersey, laboratory. After several delays, the much-touted experiment took place on February i2, i896. After exposing his assistants head to the tube for an amazing 1 hr, Edisons result was only a curvilinear murkiness. The chagrined inventor explained in the February 1 4th New York Daily Tribune that he was skeptical of his brain experiments reaching any results as the bony structure of the cranium would offer insuperable obstacles [2]. Even Mr. Edison did not foresee CT. Despite the theatric air, Edisons laboratory made significant advances. The chief contribution probably was its discovery of an improved fluorescent source to supplant the barium platinocyanide used since Roentgen. After testing up to 8000 substances [1 ], Edison announced in a cable to Lord Kelvin that calcium tungstate fluoresced most brightly in response to X-rays. This discovery by Edison the scientist sparked Edison the entrepreneur. While fluorescent screens had been described previously, Edison used the brighter calcium tungstate for his screens; he shaped the viewer like the recreational stereoscopes of the day. Thus, in March i 896, the Edison Vitascope was available to the public for home fluoroscopy [2] (Fig. 5). Edison advocated fluoroscopy over photographic plates, presumably in hope of spurring

852

DISANTIS

AJR:147, October

1986

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Fig. 4.-Pupins February 1896, image-intensified radiograph. Note easily visible shot pellets (some highlighted by arrowheads) and the excellent bone detail. (Modified from Brecher and Brecher [2].)

Fig. 5.-The Edison Vitascope, March 1896. X-ray tube (arrow); (Modified from Brecher and Brecher [2].)

fluorescent

screen

(arrowhead).

fluoroscope sales [i In the same year, the Edison Decorative and Miniature Lamp Department, a division of the General Electric Company, began manufacture of the Edison Roentgen Ray Apparatus, with equipment for both fluoroscopy and photographic plates. General Electric thus has the distinction of being the oldest X-ray manufacturer in the United States. Unshielded X-ray tubes and unshielded operators were the rule in i 896, with predictable results. Beginning in March, sporadic mention of injury associated with X-rays appeared in the literature. Early reports described a bumlike dermatitis, often with ulceration. Scientific thinking was sharply divided
regarding the source of the injurious effects, however. One

I.

noteworthy theory was expounded by X-ray tube maker, G. A. Frei, of Boston. In December i 896, he declared that skin damage was not caused by the action of the X-rays in any way. He ascribed the burns instead to the type of electrical apparatus used to power the tube. In his communication definitively titled X-Rays harmless with the static machine [41, Frei proclaimed that . . . whatever ill effects we get on our skin are caused only when we use induction coils . .., while no such effects are perceived when we employ the static machine. Interestingly, Frei manufactured static machines. No such potential impediment to objectivity affected famed investigator Nikola Tesla, however, when he, too, asserted in late i 896 that local electrical effects occurring in proximity to a working X-ray tube caused the skin damage. As to the hurtful actions of the skin . . . he stated, they are not due to the Roentgen rays but merely to the ozone generated in contact with skin [2].
,

With such influential voices proclaiming X-rays harmless, the investigators who continued to warn of potential hazard deserve credit. Elihu Thomson of the General Electric Cornpony, in November 1 896, detailed an experiment in which he incurred a severe burn after deliberately exposing the little finger of his left hand for 1/2 hr to an X-ray tube powered by a static machine [5]. Freis contention that X-rays from such an apparatus were harmless was thus discounted. Boston physician and dentist William Herbert Rollins, in the ominously titled work X-light kills [6], demonstrated that a guinea pig in a closed, electrically insulated box could be killed by X-rays. This not only cast doubt on Teslas dictum, but also stressed a previously little-appreciated caveat: Because the guinea pig died with no visible burns, lack of skin damage did not indicate that a given level of X-ray exposure was safe [2]. These conclusions were strongly reinforced on both sides of the Atlantic by a 1 91 6 paper [7] in the Italian literature with the rather melodramatic title of Autopsy of a radiologist. It detailed the demise of Doctor Ernilio Tiraboschi, who had practiced radiology for 1 4 years without protection. The autopsy showed profound aplastic anemia, and probably equally alarming to the radiologists of the day, both testes were shrunk to the size of filbert nuts. William Rollins X-light axioms were proving true: The smallest possible beam should strike the patient, and no rays should strike the observer [7]. These revelations came too late, however. The first American casualty was Clarence Madison DaIly (Fig. 6), a glasswork artisan employed by Thomas Edison. Edison had de-

AJR:147, October 1986

EARLY

AMERICAN

RADIOLOGY

853

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Fig. 6.-First American X-ray casualty. Clarence Madison DaIly (arrow) undergoes fluoroscopy by Thomas Edison. (Modified from Brown [8].)

Fig. 7.-Thomas (arrow). (Modified

Edison photographed from Brown [8].)

with his X-ray tube fluorescent

lamp

vised a project for a new means of illumination, using an X-ray tube coated with fluorescent calcium tungstate (Fig. 7). Daily used his glassblowing skills in forming these tubes, and he performed the preliminary testing in the standard i 896 fashion of placing his hand in the beam. By late that year his hands had been so badly burned that his physician urged him to stop his work. Amazingly, he continued. Speaking of Dailys
affliction,

in i 9i 2, the account their

gas

tube

era

came
was

to a close.
inefficient,

Taking
dangerous,

into

equipment,

which

and impossible to calibrate, by these pioneers remains gence, and selflessness. REFERENCES

the level of advances achieved a tribute to their ingenuity, diii-

Edison

commented

with

pragmatic

understatement,

. . . I

started

to make

a number

of these

lamps,

but I soon

found that the rays had affected poisonously my assistant, Mr. Daily, so that . . . his flesh commenced to ulcerate. I then

concluded that it would not be a very popular kind of light, so I dropped it . . . [8]. That decision came too late for Daily, however, who died in i 904 of metastatic squamous carcinoma after i 44 failed skin grafts and bilateral arm amputations [8]. In addition to Daily, Percy Brown lists 26 Americans who

died

as a result

of their

pioneering

work

with

X-rays.

The eclectic group presented here, culled from such diverse fields as photography, physics, and medicine, provides a mere sampling of the people important in our specialtys fledgling years. With the advent of the Coolidge hot cathode-ray tube

1 . Grigg ERN. The traiof the invisible light. Springfield, IL: Thomas, 1965 2. Brecher R, Brecher E. The rays. A history of radiology in the United States and Canada. Baltimore: Williams & Wilkins, 1969 3. Wright AW. Experiments upon the cathode rays and their effects. Am J Sci March 1896;i(i 5):235-244 4. Frei GA. X-rays harmless with the static machine. Elect Engineer Dec. 23, 1896;22:651 5. Thomson E. Roentgen rays act strongly on the tissues. Elect Engineer Nov. 25, 1896;22:534 6. Rollins W. X-Iight kills. Boston Med Surg J Feb. 1 4, 1901;i 44:173 7. Bruwer AJ. Classic descriptions in diagnostic roentgenology, vol. 1 . Springfield, IL: Thomas, 1964 8. Brown P. American martyrs to science through the Roentgen rays. Springfield, IL: Thomas, 1936