The Action of Roentgen Rays or Radium on Inflammatory Processes

WHENEVER treatment with roentgen rays or radium is mentioned, the idea that rises in the average mind is that the speaker or writer must refer to malignant tumors. Many physicians are not aware of the favorable influence of these agents on various forms of acute or chronic inflammation. And yet the therapeutic value of irradiation in inflammations has been so thoroughly substantiated and the testimony is so generally favorable that one wonders why the method is not used more than it is. Perhaps the very multiplicity of lesions for which radiotherapy has been claimed to be effective has led to a natural skepticism. Also, the multiplicity of explanations which have been advanced to account for the influence of roentgen rays or radium on inflammatory conditions has probably led many physicians to discredit the evidence or to ascribe it either to enthusiasm or to psychic factors. Indeed, without a satisfactory and convincing explanation, it would be difficult to believe that the same agent could be therapeutically effective against so many different forms of inflammation in different parts of the body. And yet the reason appears to be simple and rests on sound and abundant experimental evidence. Others who have heard or read of the therapeutic possibilities of irradiation in inflammatory processes hesitate to make use of the method because they fear deleterious effects on the skin or gastro-intestinal disturbances such as are observed in connection with the treatment of malignant tumors. When treating neoplasms the aim is to deliver the largest dose compatible with the integrity of the surrounding tissues. When treating inflammatory lesions, on the contrary, only small or moderate doses are employed. Doses that might strain the tolerance of the skin are unnecessary and should be avoided as potentially dangerous. For acute inflammations especially, the doses required are so small that the skin or the gastro-intestinal tract cannot possibly be affected. Hence any fear on this score is unfounded. The treatment of inflammatory processes with roentgen rays is far from new. Indeed, it goes back to 1902 and 1903. An interesting fact is that some of the earliest therapeutic trials were made in this country, but they did not receive any attention until the successful results had been repeatedly confirmed by others here and abroad. In connection with some varieties of inflammation the idea of treating them with roentgen rays arose from the chance observation of improvement following roentgenographic exposures for diagnostic purposes. Acute Inflammations Many varieties of acute inflammation yield rapidly to a small dose of roentgen rays. By a small dose is meant a dose representing less than half of the tolerance dose of the skin; a dose as small as a fourth of the so-called erythema dose, or even less, is often sufficient, but this may vary somewhat according to the character and stage of the lesion in each case.