1930s radiology

Memorial to the early X-ray martyrs 

On the 4th April 1936 a memorial to the X-ray martyrs of the world was erected in the grounds of St. George’s Hospital in Hamburg and the BJR recorded the event (BJR 1936;  9(102):351-353). The list of the British martyrs is recorded. These early X-ray and radium workers suffered greatly from radiation injuries and premature death in the period prior to the understanding of the need for radiation protection and safe handling of radiation sources. The monument is still standing and may be visited.

Radiology
 

Image source: Hermann Vogel

In December 1930 AE Barclay gave the Silvanus Thompson Memorial Lecture on the dangers of specialisation in medicine (Barclay BJR1931; 4(38): 60-82). His life and contributions were reviewed by Jean Guy (Guy BJR 1988; 61(732): 1110-1114). It is difficult to overemphasise the contributions that Barclay made to British radiology. His paper on medical specialism is masterly and gave an account that still has relevance today.  

One of the most significant events of the 1930s was the publication of “British Authors” which was the highly influential multi-author textbook covering all aspects of medical imaging. Diagnostic radiology can be seen to have come of age by the end of the 1930s and this book celebrated the knowledge that had been obtained in the previous 40 years. Radiology was progressing rapidly in the 1930s. The editors of the books were EW Twining, C Cochrane Shanks and Peter Kerley and the first edition of “A Text-Book of X-ray Diagnosis by British Authors” was first published in 1938 and was reviewed in the Journal (BJR 1938; 11(130): 702-704).

Antibiotics did not exist in the 1930s and many physical treatments for infectious disease were used. In May 1931 G Simon (Simon BJR 1931; 4(41): 197-202) wrote on the treatment of pneumonia with diathermy. The main value would seem to be of symptomatic relief.

F Hernaman-Johnson was the first warden of the Fellowship of the British Association of Radiologists and in June 1936 at their Annual Meeting he spoke about the Fellowship (Hernaman-Johnson BJR 1936; 9(104): 533-545). Radiology had developed as a speciality by 1936 and the University of London had created a chair of radiology. The Fellowship regulations were summarised.

Ian Rawlins from the National Gallery wrote a most interesting study of the radiography of paintings in April 1939 (Rawlins BJR 1939; 12(136): 239-245). In October 1932 there is an interesting discussion of the visibility of X-rays by the unaided eye (BJR 1932; 5(58): 738-739), which had been initially observed by Wilhelm Röntgen.

In 1939 Major DB McGrigor described the localisation of foreign bodies applicable to wartime (McGrigor BJR 1939; 12(143): 619-631). As he put it: “….many radiologists will be employed in war hospitals at home and abroad.”

A number of significant deaths are recorded with some listed below. 


Sir Robert Jones (1857-1933)

Sir Robert Jones from Liverpool was a pioneer of modern orthopaedic surgery and was an enthusiastic supporter of the use of the new X-rays soon after their discovery in 1895. He encouraged the work of the pioneer Liverpool radiologist Charles Thurstan Holland who wrote the obituary of his friend (Thurstan Holland BJR 1933; 6(62): 116).

 

Dr Stanley Melville (1867-1934)

Dr Stanley Melville was the BIR president and died suddenly in 1934 (Kaye and Barclay BJR 1934; 7(77): 257-262). Following the death of Ironside Bruce in 1921, Melville became a major force in the formation of the influential X-ray and Radium Protection Committee.

StanleyMelville

Image source: Kaye and Barclay BJR 1934; 7(77): 257-262

 

Marie Sklodowska-Curie (1867-1934)

Marie Curie made huge contributions to medicine, physics and radiology. The BJR obituary was by her colleague Claude Regard from the Radium Institute in Paris (Regard BJR 1934; 7(81): 522-530). Eve Curie wrote an interesting paper describing the lives and work of her parents Pierre and Marie Curie and appearing in the July 1950 BJR (Curie BJR 1950; 23(271): 409-412).

 

Lord Rutherford of Nelson  (1871-1937)

Lord Rutherford had been an honorary member of the BIR since 1910 and died in 1937 (BJR 1937; 10(119): 822-823). He made many contributions to nuclear physics. He was concerned with the development of radiology and in 1919 supported the Cambridge Diploma in Medical Radiology and Electrotherapy, which became the necessary examination for radiologists. Lord Rutherford opened the Annual Congress of the BIR in 1931 and his opening address is reprinted in full (Rutherford BJR 1932; 5(49): 3-9) and in it he describes his encounters with x-rays and radiology.

 

Antoine Béclère (1856-1939)

Antoine Béclère (BJR 1939; 12(137): 319-320) from Paris was a French pioneer radiologist and had a huge influence on the development of European radiology. His dictum was that “In order to know a subject well, one must teach it.”

 

Edward Wing Twining (1887-1939)

Edward Wing Twining from Manchester died prematurely in 1939. His obituary (BJR 1939; 12(139): 442-443) was published in the BJR in the month before his masterly study of the third and fourth ventricles (Twining BJR 1939; 12(139): 385-418). Twining made many contributions to neuroradiology and is remembered for “Twining’s line,” however he also contributed to the development of classical tomography (Twining BJR 1937; 10(112): 332-347). Edward W Twining was, with C Cochrane Shanks and Peter Kerley, a joint editor of the influential “A Text-Book of X-ray Diagnosis by British Authors” that was first published in 1938, and the third volume is dedicated to him. 

 

Florence Ada Stoney  (1870-1932)

Florence Ada Stoney was a pioneer female radiologist in the UK (BJR 1932; 5(59): 853-858). Her sister was the physicist Edith Stoney. 

FlorenceStoney

Image source: BJR 1932; 5(59): 853-858


Florence Stoney was the first female radiologist in the UK. In 1902 she started the X-ray work at the Royal Free Hospital and New Hospital for Women (Elizabeth Garrett Anderson Hospital).  She visited the United States just before the outbreak of the Great War to see X-ray work and gave a most interesting account in the Archives of the Roentgen Ray (the forerunner of the British Journal of Radiology) in October 1914. She visited the eastern USA towns and Schenectady. She found the doctors very helpful and commented that “medical women not being kept out of everything as in England.”  

There was a considerable concern for radiation protection. Nowhere was the operator left exposed to radiation apart for fluoroscopy. There was only limited use of fluoroscopy. She described the use of a mirror to observe the fluorescent screen with the operator behind a lead screen. Bismuth (not barium) was used for gastrointestinal diagnosis and from 6 to 40 photographs were taken to diagnose gastric or duodenal ulcers in those days before endoscopy. It was a common practice to include a reduced sized print of the abnormality with the written report.

She saw treatment with irradiation. This was mainly carried out using radium emanation (radon), which was contained in small metal needles that were inserted directly into the tumour. She visited Philadelphia and observed radiotherapy with X-rays. She was impressed by the treatment of a 36-year-old woman with breast cancer who was treated directly after surgery. She said that they used heavy doses, heavily filtered and frequently repeated. The surface was carefully marked out and exposed in turn with a crossfire being directed on the tumour from as many points as possible.

When war started on August 4th 1914 the War Office in London refused her offer of service because she was a woman.  By this time, she had 13 years experience in radiology.  Florence and her sister had a complete X-ray installation prepared including a Coolidge tube that she had acquired in the USA. They joined the author Mrs St. Clair Stobart in organising a voluntary women’s unit and Florence organised the medical part of the surgical unit entirely staffed by women. 

Florence Stoney had a firm faith in the potential capacity of women to fill positions of the highest responsibility and remains an inspiration. She had a gentle kindness and rich sympathy for suffering – showed courage in her own last, long and painful illness. 

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