The Action of Roentgen Rays on Inflammatory Conditions

During the past fifteen years, an increasing number of radiologists and other physicians have become interested in roentgen therapy for inflammatory conditions. Some chronic inflammations, notably of the skin and lymph nodes, had been treated with roentgen rays as early as 1896 and 1897, but this had been done empirically. Early trials of roentgen therapy for chronic inflammations were made in this country, but it is only true to say that some of these attempts were not systematically followed up and often they were unknown to all but a few. As for the treatment of acute inflammations, much of this was first carried out in various European countries, and American radiologists have been a little slow in following the lead. It was only after the World War that the treatment of chronic and especially of acute conditions became an established procedure. This was due to the work of many physicians, but special credit is due Heidenhain and Fried,2 who treated in this manner a large number of different kinds of inflammation. Their reports have had a greater influence, perhaps, in stimulating the use of roentgen rays in the treatment of inflammations than those of any other medical writers. There is no longer any doubt that roentgen rays often have a beneficial effect on many varieties of acute and chronic inflammation. The evidence is now so abundant that it cannot be disregarded. It has been difficult for internists and surgeons, and for some radiologists also, to understand how an agent which has been used so largely to treat malignant tumors can also be an effective means of treating acute or chronic inflammatory processes. In malignant neoplasms, the rays act mainly by destroying malignant cells. How can this be reconciled with the treatment of inflammatory lesions? One reason for this difficulty is that so few physicians have been familiar with the experimental background of roentgen therapy and with the sensitiveness of different kinds of tissue and cells to the rays. A second reason is the great variety of inflammations for which the therapeutic value of roentgen rays has been claimed, and the lack of a convincing explanation of the action of the rays on these many different conditions. Still another reason for the hesitation of internists and surgeons to take advantage of this method of treatment for the benefit of their patients has been the fear of deleterious changes such as are not infrequently observed following the treatment of malignant tumors. In 1931 I attempted to explain the action of the rays on acute and chronic inflammations. This explanation was based on a knowledge of the results of many experiments on animals and of the large number of clinical observations to be found in the medical publications of different countries over many years.