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X-Ray Measurements and Radium Protection Catch Up, 1914–22

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Strengthening International Regimes

Part of the book series: Palgrave Studies in International Relations ((PSIR))

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Abstract

Two contrasts between medical work with X-rays and with radium highlighted previously would fade during World War I and in the early 1920s. Under pressure from physicists, X-ray clinics would begin to use ionization measurements, thus closing the gap between clinical measurements of X-rays and radium. Prompted by public concern and the reaction of insurance companies as well as workmen’s compensation schemes, radium protection would grow in importance after the War and would become, like X-ray protection, the subject of special studies and recommendations at the national level in France, Britain, and the United States but not in Germany, where there was less sign of public concern. By contrast, the pattern of international cooperation would remain the same. Individual scientists and physicians read the literature published in other countries, often knew their colleagues, and sometimes reacted to work published abroad. Likewise, the various national and local professional organizations concerned with X-rays and radium followed the others’ proceedings and sometimes reacted with similar efforts on dosimetry and protection. But there were still no international norms on these issues, which remained defiantly complex and difficult even as the use of X-rays and radium expanded dramatically.

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Notes

  1. 1.

    Untersuchungen und Betrachtungen über das Problem der Dosimetrie. Strahlentherapie. 1922;14:362–88, at 388.

  2. 2.

    In the discussion following Laquerrière, Des dangers des installations de Radio et de Radiumologie. Rapport à une compagnie d’assurance sur le “risque” du personnel et des visiteurs dans un institut de Radio et de Radiumologie. Bull Off Soc Franc Electroth Radial. 1921 May;132–7.

  3. 3.

    For the President’s appeal, see Levy-Dorn’s opening address to the Society’s congress, Verh Deut Rönt Ges. 1914;10, at 16, and for the creation of the Commission see the business meeting, at 18: “Der Zweck dieser Kommission soll sein, die Dosimeter, die landläufig sind und sich irgendwie bewährt haben, untereinander zu vergleichen, damit so feste Daten bekannt werden, auf die Sie sich einigermassen verlassen können; denn wie Sie ja wissen, geben die verschiedenen Dosimeter ganz verschiedene Auskünfte.” Of the sixteen original members, seven are readily identifiable as physicians (including Christen), five as nonphysicians and the remaining four are not readily classifiable.

  4. 4.

    For the decision to continue the work of the ·commission, see the II. Rundschreiben des Vorsitzenden. Fortschr Röntgenstr. 1915;23:72: “Es wäre recht erfreulich, wenn die Dosimeter­kommission nach dem Kriege mit den erreichbaren Resultaten hervortreten würde, die wir Daheimgebliebenen unter dem Schutze unserer mächtigen Heeresorganisation fast wie im Frieden leisten könnten.”

  5. 5.

    Fortschr Röntgenstr. 1915;23, at 213: “Der einfache Vergleich der Dosimeter ist von den meisten Arbeitern ausdrücklich oder implizite als unlösbar bezeichnet worden und es hat sich die Notwendigkeit ergeben, zuerst irgendein exaktes Verfahren der Messung der Röntgenstrahlen zu schaffen, und wäre es eine noch so komplizierte Laboratoriumanordnung ….Dazu sollte alles, was Physik und Mathematik geleistet haben und leisten können, herangezogen werden.” Holzknecht’s biography is at Radiation Oncology Institute, Radiological Oncologists: The Unfolding of a Medical Specialty [Internet]. RO Institute. 2023. Available from: https://www.roinstitute.org/About-the-ROI/The-ROI-Juan-A-del-Regato-Fund/Radiological-Oncologists, accessed October 22, 2023.

  6. 6.

    For these papers, which were never actually read to the group but were published together, seeArbeiten und Verhandlungen der Sonderkommission für Dosimetervergleich der Deutschen Röntgengesellschaft. II Gruppe, Fortschr Röntgenstr. 1915;23:213–300, abgeschlossen im Juli 1915; Arbeiten und Verhandlungen des Sonderausschusses für Röntgenstrahlenmessung der Deutschen Röntgengesellschaft, III. Gruppe.:509–32, abgeschlossen am 22 XI. 1915; IV. Gruppe, Fortschr Röntgenstr. 1916;24:373–423, abgeschlossen am 15. VI. 1916; V. Gruppe, Fortschr. Röntgenstr. 25 (1917–18) 55–71; und Fortschr. Röntgenstr. 26. 1918;38–41.

  7. 7.

    The British “Measurement” or “Dosimetry” Committee was formed late in 1913, see the Annual Report. Journal of the Röntgen Society. 1914;10:88–97 and reported inconclusively in 1915, see the “Interim Report on the Standardisation of X-ray Dosage,” Interim Report on the Standardisation of X-ray Dosage. Journal of the Röntgen Society. 11:102–10, authorized to be printed in full by the Council at its meeting held on 1 June 1915. The Committee had ten members when it reported, of whom seven were nonphysicians, two were practicing physicians and one was a retired physician. For the French conclusion, see Ledoux-Lebard R, Dauvillier A. Principes rationnels de dosimétrie radiologique. Considération théoriques et pratiques. Journal of Radiology and Electrology. 1916;2:153–62, at 153: “…il est impossible d'arriver à une solution satisfaisante du problème du dosage des rayons X parce qu'il se présente sous une forme beaucoup trop complexe pour que soient réalisables des appareil s de mesure donnant des indications précises et toujours comparables à elles-mêmes.”

  8. 8.

    Grossmann G (Charlottenburg). Grundprinzipien der Dosimetrie. Fortschr Röntgenstr. 1914;22:101–42.

  9. 9.

    For experiments that indicated that the Kienböck strips and the Sabouraud-Noiré pastilles gave parallel results over a wide range of hardnesses, thus demonstrating that Grossmann’s “theoretical” considerations were incorrect, see Meyer H. Fortschr Röntgenstr. 1915;23:75–6. It was later recognized that these experiments merely demonstrated that the strips and the pastilles were equally insensitive to changes in X-ray dosage.

  10. 10.

    Krönig B (o. ö. Prof. der Geburtshilfe und Gynäkologie an der Universität Freiburg i. Br., Direktor der Univ.-Frauenklinik), Friedrich W (Privatdozent für Physik an der Universität Freiburg i. Br., wissenschaftlicher Assistent an der Univ. Frauenklinik). Physikalische und Biologische Grundlagen der Strahlentherapie, III. Sonderband zur Strahlentherapie. Berlin: Urban and Schwarzenberg; 1918. There is a clumsy but readable translation by Schmitz H. The Principles of Physics and Biology of Radiation Therapy. Rebman; 1922). For the sponsors (who included industry, government, private patrons and a local scientific society), see the Forward to the German edition.

  11. 11.

    Villard P. Instruments de mesure à lecture directe pour les rayons X. Arch Elec Med. 1908;16:692–9.

  12. 12.

    For the “megamegaion,” see Szilard B. Appareil pour la mesure de la quantité de rayons X. Radium. 1910;7:223–4 and on the Absolute Measurement of the Biological Action of the X-rays and Gamma Rays. Arch Rönt Ray. 12:3–20.

  13. 13.

    For references to this literature, see Fricke H, Glasser O. Studies on the Physical Foundations of Röntgen-Ray Therapy I. American Journal of Roentgenology. 1924;11:435–42.

  14. 14.

    If there were limits on human experimentation, they were not mentioned in the professional journals. Certainly nothing like current constraints on human experimentation existed.

  15. 15.

    The full report of this work is Unsere Methode der Röntgen-Tiefentherapie und ihre Erfolge, V. Sonderband zu Strahlentherapie. Berlin: Urban and Schwarzenberg; 1920. For a summary account, see Wintz H (Erlangen). Die Grundlagen einer erfolgreichen Röntgentiefentherapie. Verh Deut Rönt Ges. 1920;11:64–8, auf Einladung der D. R.-G., with discussion at 92–98.

  16. 16.

    Bazzano LA, Durant J, Brantley PR. A Modern History of Informed Consent and the Role of Key Information. Ochsner Journal. 2021 Spring;21(1):81–85. https://doi.org/10.31486/toj.19.0105, accessed December 20, 2023. PMID: 33828429; PMCID: PMC7993430.

  17. 17.

    See the comments of Albers-Schönberg in the discussion following Wintz, ibid.

  18. 18.

    See, for example, Mikhailov, VF, Zasukhina, G.D. A New Approach to the Stimulation of the Body’s Defense Systems with Low Radiation Doses. Biology Bulletin Reviews 10, 475–482 (2020). https://doi.org/10.1134/S2079086420060031, accessed October 23, 2023.

  19. 19.

    See, for example, Frankel M (Charlottenburg). Die Reizdosenanwendung, ihre Bedeutung für die Röntgentherapie. Verh Deut Rönt Ges. 1920;11:89–92, or the full text Die Bedeutung der Röntgen-Reizstrahlen in der Medizin mit besonderer Einwirkung auf das endokrine System und seiner Beeinflussung des Karzinoms. Strahlentherapie. 1921;12:603–38 and 850–99.

  20. 20.

    Fernau A, Pauli W (aus der k. k. Radiumstation im allgemeinen Krankenhause und dem Laboratorium für physikalisch-chemische Biologie der k. k. Universität Wien, mit Unterstützung der Fürst Liechtenstein-Spende). Über die Einwirkung der durchdringenden Radiumstrahlung auf anorganische und Biokollide. I, Biochemische Zeitschrift. 1915;70:426–41, eingegangen am 4 Juni 1915. This W. Pauli was the father of the well-known physicist of the same name.

  21. 21.

    Christen T (aus der Strahlenforschungsstelle der Reiniger, Gebbert und Schall-A.-G., München). Energiemessung von ionisierenden Strahlen insbesondere von Röntgenstrahlen. Physikalische Zeitschrift. 1916;17:23–5, eingegangen 17 Januar 1916, at 25: “…ein Zweifel auftaucht ob denn auch wirklich der Sättigungsstrom der in der Luft absorbierten Energie streng proportional sei oder ob nicht am Ende das als Proportionalitätskonstante aufzufassende Umsetzungsverhältnis zwischen der absorbierten Energie und der Ionisation eine Funktion der Wellenlänge sei, etwa auf Kosten von gleichzeitig entstehender Erwärmung der Luft”; Glocker R. Die Messmethoden der Röntgenstrahlen. Physikalische Zeitschrift. 1917;18:302–15 and 330–8, eingegangen 14 Mai 1917, at 306: “Alle Ionisations­ messungen von Strahlungsenergien beruhen auf der Voraussetzung, dass die pro Volumeneinheit des Gases erzeugte Ionenzahl, unabhängig von der Härte der Strahlen, direkt proportional der in der Volumeneinheit absorbierten Strahlungsenergie ist.”

  22. 22.

    Holthusen H (aus der Medizinischen Klinik Heidelberg). Über die Bedingungen der Röntgestrahlenenergiemessung bei verschiedenen Impulsbreiten auf luftelektrischem Wege. Fortschr Röntgenstr. 1918;26:211–31.

  23. 23.

    This controversy is recounted in more detail in Serwer DP. The Rise of Radiation Protection: Science, Medicine and Technology in Society, 1896–1935. Brookhaven National Laboratory; Dec 1976. 161–9.

  24. 24.

    Holthusen (Hamburg). Über die Beziehungen zwischen physikalischer und biologischer Dosierung. Verh Deut Rönt Ges. 1924;15. or Fortschr Röntgenstr. 32 (1. Kongressheft 1924):73–9.

  25. 25.

    Meyer H (Privatdozent), Ritter H. Experimentelle Studien zur Feststellung eines biologischen Normalmasses fur Röntgenstrahlen. Strahlentherapie. 1912;1:183–8, aus dem Institut für Strahlenbehandlung der Königl. Dermatol. Klinik zu Kiel (Direktor: Prof. Klingmüller), at 183:“…da es sich in der Therapie stets darum handelt, eine Wirkung auf biologische Prozesse hervorzurufen, seien sie nun normaler oder pathologischer Natur, so wäre es natürlich das beste, wenn man die Abstufung der Wirkung, d. h. also die Dosierung an der Hand eines biologischen Messverfahrens vornehmen könnte.”

  26. 26.

    Jüngling O (Priv.-Dozent, Assistenzarzt der Chirurgischen Universitätsklinik Tübingen, Vorstand: Prof. Dr. Perthes). Die praktische Verwendbarkeit der Wurzelreaktion von Vicia faba equina zur Bestimmung der biologischen Wertigkeit der Röntgenstrahlung. Münchener Medizinische Wochenschrift. 1920;672:1141–4.

  27. 27.

    Russ S. A Suggestion for a New X-Ray Unit in Radiotherapy. Archives of Radiology and Electrotherapy. 1918 Dec;23(7):226–32. A different “rad” would come into common use after World War II.

  28. 28.

    Küstner H (Göttingen). Vorarbeitung zur Schaffung eines Standardgeräts zur Dosierung der Röntgenstrahlen,” from the report of the “Sitzung der von der Deutschen Röntgengesellschaft eingesetzten Kommission zwecks Schaffung eines Standardinstrumentes für die Röntgenstrahlenmessung,” am 21 Oktober 1923 in Göttingen. Fortschr Röntgenstr. 1923;31:483–7, at 485: “Seine Anwendung kann den Arzt keinesfalls vor Schadenersatzansprüchen des Patienten schützen. Die Firma Reiniger, Gebbert und Schall, Erlangen, von der alle Streifen, Entwickeln und Geräte bezogen waren, lehnt diese Verantwortung auf Entschädigungsansprüche in ihrer Gebrauchsanweisung ebenfalls ab.”

  29. 29.

    Bachem A (Priv.-Doz., aus dem Institut für physikalische Grundlagen der Medizin in Frankfurt a. M., zurzeit Chicago). Zur praktischen Dosierung der Röntgenstrahlen verschiedener Härte. Strahlentherapie. 1922;13:605–10.

  30. 30.

    Grebe L (Röntgen-Forschungs u. Unterrichtsinstitut der Universität Bonn), Martius H (Universitäts-Frauenklinik in Bonn). Vergleichende Messungen über der Grosse der zur Erreichung der Hauterythems gebrauchlichen Röntgenstrahlenmenge. Strahlentherapie. 1924;18:395–409.

  31. 31.

    Friedrich W, Glasser OA. Untersuchungen und Betrachtungen über das Problem der Dosimetrie. Strahlentherapie. 1922;14:362–88.

  32. 32.

    Sitzung der von der Deutschen Röntgengesellschaft eingesetzten Kommission zwecks Schaffung eines Standard-instrumentes für die Röntgenstrahlenmessung, am 21 Oktober 1923 in Göttingen. Fortschr Röntgenstr. 1923;31:483–7.

  33. 33.

    Bekanntmachung betreffend die Eichung von Röntgenstrahlen Dosismessern in der Physikalisch-Technischen Reichsanstalt. Fortschr Röntgenstr. 1923;31:565–6. and Behnken (Berlin). Die Eichung von Dosismessern in absolutem Masse in der Physikalisch-technischen Reichsanstalt. Verh Deut Rönt Ges. 1924;15:92–4.

  34. 34.

    Behnken H. Die Vereinheitlichung der Röntgenstrahlen-Dosismessung und die Eichung von Dosismessern. Zeitschrift fur technische Physik. 1924;5:3–16, eingegangen 4 September 1923.

  35. 35.

    Dessauer F. Über einige Wirkungen von Strahlen. I. Zeitschrift für Physik. 1922;12:38–47, Mitteilung aus dem Universitäts­ institut für physikalische Grundlagen der Medizin in Frankfurt a. Main, eingegangen am 30 September 1922; and Blau M, Altenburger K. Über einige Wirkungen von Strahlen. II. Zeitschrift für Physik. 1922;12:315–29, Mitteilung aus dem Universitäts­ institut für physikalische Grundlagen der Medizin, eingegangen am 2 November 1922. See also Dessauer F (Direktor des Instituts für physikalische Grundlagen der Medizin an der Universität Frankfurt a. M.). Dosierung und Wesen der Röntgenstrahlenwirkung in der Tiefen therapie vom physikalischen Standpunkt, Strahlentherapeutische Monographien Band II. Dresden and Leipzig: Theodor Steinkopff; 1923. especially Teil II. Apparently independent of Dessauer, an English physicist also proposed the hit theory and used it to calculate the size of the targets, see Crowther JA. Some considerations relative to the action of X-rays on tissue cells. Proceedings of the Royal Society. 1924 Apr 1;96B(674):207–11.

  36. 36.

    See, for example, Packard C (Columbia University, Institute of Cancer Research, F. C. Wood, Director). The Measurement of Quantitative Biological Effects of X-Rays. The Journal of Cancer Research. 1926 Oct 1;10(3):319–39, and Mottram JC. The Survival Curves of Cells Under Radiation. Journal of Cancer Research. 1927;11:130–4.

  37. 37.

    Holthusen H (Hamburg). Die Wirkung der Röntgenstrahlen in biologischer Hinsicht. Verh Deut Rönt Ges. 1924;15 (2. Teil 1924):3–4, from the Zwischentagung der Deutschen Röntgen-Gesellschaft als Abteilung 22 der 88. Versammlung der Gesellschaft Deutscher Naturforscher und Ärzte in Innsbruck, 24–26 September 1924, at 4: “Die vielfältigen Wege, auf denen sich die Strahlen im Körper auswirken können, lassen sich nicht auf eine Formel bringen.”

    See also the other papers and the discussion, ibid., 4–13.

  38. 38.

    Dessauer, Dosierung und Wesen …, note 32.

  39. 39.

    As it turned out, the site of the primary lesion was the bone marrow, not the components of the blood in circulation, which are relatively resistant to radiation damage, see Jolly J, Laccasagne A. De la résistance des leucocytes du sang vis-a-vis rayons X. C R Soc Biol (Paris). 1923;89:379. and Laccasagne A, Lavedan J. Les modifications histologiques du sang consécutives aux irradiations expérimentales. Paris Med. 1924 Feb 2;21:97–103.

  40. 40.

    V. Jagié N, Schwarz G, Van Siebenrock L (aus der I. Medizinischen Universitätsklinik in Wien, Vorstand: Prof. C. v. Noorden). Blutbefunde bei Röntgenologen. Berlin Klin Wschr. 1911;482:1220–2.

  41. 41.

    The Autopsy of a Radiologist. Arch Rönt Ray. 1914 Apr 1;18(11):393–4. The radiologist was Emilio Tiraboschi, who worked at the Ospidale Maggiore in Bergamo. The original report was published in Gavazzeni S, Minelli S. L’Autopsie d’un radiologo. Radiologia Medica. 1914 Feb;1:66–71.

  42. 42.

    The Injurious Effects Produced by X-rays; a Discussion at the Röntgen Society on 1 February 1916. Journal of the Röntgen Society. 1916;12:38–56. Sidney Russ (D. Sc.) opened the discussion. The comment quoted here was by Reginald Morton, at 40.

  43. 43.

    The comment was by N. S. Finzi, ibid., at 44.

  44. 44.

    Editorial Notes. Journal of the Röntgen Society. 1919 Jul;15:66.

  45. 45.

    Mottram JC. The Red Cell Blood Content of Those Handling Radium for Therapeutic Purposes. Archives of Radiology and Electrotherapy. 1920 Dec 1;25(7):194–7, read before the Pathological Society of Great Britain and Ireland, 3 August 1920. Mottram had already reported abnormalities in the blood of these workers, see Mottram JC (M. B.), Clarke JR. The Leucocytic Blood-Content of Those Handling Radium for Therapeutic Purposes. Proc Roy Soc Med. 1920;13(11):25–30, reprinted in Archives of Radiology and Electrotherapy. 1919;24:345–50. It turned out later that the immediate cause of death in two of these three cases was not pernicious anemia, but Mottram thought that the anemia had weakened the resistance of the workers, see Foreign Letters. Journal of the American Medical Association. 1921 May 21;762:1412–3.

  46. 46.

    For one product of this collaboration, see Russ S (D. Sc.), Chambers H (M. D. Lond.), Scott G, Mottram JC (M. B. Lond.). Experimental Studies with Small Doses of X-Rays. The Lancet. 1919 Apr 1;193(4991):692–5, undertaken at the request of the Medical Research Council and funded by the Cancer Investigation Fund of Middlesex Hospital.

  47. 47.

    Mottram JC. Histological Changes in the Bone Marrow of Rats Exposed to the γ Radiations from Radium. Archives of Radiology and Electrotherapy. 25:197–9. and Mottram JC. The Effect of Increased Protection from Radiation upon the Blood Condition of Radium Workers. Archives of Radiology and Electrotherapy. 1921;25:368–72.

  48. 48.

    For Bruce’s obituary, which did not mention the cause of death but identified him as a “martyr,” see Archives of Radiology and Electrotherapy. 1920;25:338. The case was later described, without identifying the victim, in Larkin FE. A Case of Acute Aplastic Anemia. Archives of Radiology and Electrotherapy. 25:380–2. Such were the sensitivities of a profession that had chosen to ignore this particular risk, but the lay press had already identified the victim and his disease.

  49. 49.

    The MacKenzie Davidson Memorial Fund. Archives of Radiology and Electrotherapy. 24:306–7, where the original appeal and list of sponsoring luminaries (including A. Bonar Law, Stanley Baldwin, J. J. Thomson, Coolidge, and leading lights of the British medical radiological community) is reproduced. Failing an institute, plans called for a university chair.

  50. 50.

    Report of the Special Board of Medicine upon a proposal to establish a Diploma in Medical Radiology and Electrology in the University [of Cambridge], dated 20 May 1919 and reprinted under the heading British Association of Radiology and Physiotherapy. Archives of Radiology and Electrotherapy. 24:31–4. This report to the Vice-Chancellor ·was communicated to the Senate, which on 17 June 1919 promulgated detailed plans for the syllabus of subjects to be covered by the examination, see the account in The Work of the British Association of Radiology and Physiotherapy. Archives of Radiology and Electrotherapy. 24:209–16. In the first of these reports, it is noted that a physician had contributed £1000 to cover the University’s initial expenses in setting the examination, which would eventually become self-supporting from fees charged the candidates. The examination was given for the first time in July 1920, and the physicians were relieved that “no question on higher mathematics was asked, and a knowledge of only simple calculations would be required…,” see The Diploma in Medical Radiology and Electrology. Archives of Radiology and Electrotherapy. 25:164–8, where the entire examination is reproduced.

  51. 51.

    “Report of the Special Board,” ibid., at 32: “…only medical men who have received special training in Physics and Practical Radiology, Electrotherapy and Electrology generally, are in a position to understand and foresee not only the development of their application to diagnosis and treatment, but also their limitations and dangers.”

  52. 52.

    Knox’s letter to the Times was printed on March 29, 1921. It has been reprinted in Nauman JD. Pioneer Descriptions in the Story of X-ray Protection. In: Classic Descriptions in Diagnostic Röntgenology. Springfield Illinois: Charles C. Thomas; 1964:311–39. For Knox’s war-time work with Kaye, see Captain Knox R, Kaye GWC. The Examination of Aircraft Timber by X Rays, a contribution to a “General Discussion on the Examination of Materials by X Rays” held jointly by the Faraday Society and the Röntgen Society. Archives of Radiology and Electrotherapy. 1919 Apr 29;24.; G. W. C. Kaye, (0. B. E., M. A., D. Sc., R. A. F.), “The Examination of Aircraft Timber by X Rays,” a contribution to a “General Discussion on the Examination of Materials by X Rays,” held jointly by the Faraday Society and the Röntgen Society, 29 April 1919 and abstracted in Archives of Radiology and Electrotherapy. 24 (1919–20) 295–97.

  53. 53.

    Andrews C. X-rays and Propaganda. Journal of the Röntgen Society. 1921;17:129–32, read 21 April 1921, at 131–2.

  54. 54.

    The most detailed of these retrospective accounts is by Melville S. A Discussion on the International Protection Recommendations. The British Journal of Radiology. 1932 Jan 14 and 1931 Nov 19;2:215–233, at 218: “In the spring of 1921 radiology was very near to what might have been a terrific onslaught by the Press. On my way home from a Memorial Service for our old friend Ironside Bruce, whose untimely death caused much concern, I discussed with the Secretary to the Medical Society of London the many references that had been made in the public Press to his death. To my amazement, he informed me that he had been discussing the matter with a member of one of our most powerful papers, and that they had every intention of launching into a warning to the public against the dangers of X rays. I found on enquiry at the office of the paper that my information was correct.” See also, Kaye GWC. Röntgenology: Its Early History, Some Basic Physical Principles and the Protective Measures. London: William Heinemann; 1928:69.

  55. 55.

    For one of many articles, see Aubertin C, Beaujard E. Actions des rayons X sur le sang et la moelle osseuse. I. Action d’une dose unique d’intensité moyenne en irradiation totale. Arch Med Exp. 1908;20:273–88.

  56. 56.

    Mignon (M. le Docteur). La Protection en radiologie. Journal of Radiology and Electrology. 1918;3:165–72, communication faite à la Réunion des radiologistes de la XIIIe Région, with discussion. It was Belot who emphasized that this was an isolated case.

  57. 57.

    Bordier H (Professeur à la Faculté de Médecine de Lyon). Les dangers du radium. Utilité des mesures de protection. Bulletin of the Academy of Medicine (Paris). 1921;85:416–7, séance du 29 mars.

  58. 58.

    Reid R. Marie Curie. New York: New American Library; 1974. gives an extensive account of this post-war period in France and Curie’s trip to the United States in Chapter 20 and 21. Reid is, however, wrong in saying (at p. 240) that there was no committee concerned with radium protection in France as late as 1922.

  59. 59.

    Broca. Sur les dangers des radiations pénétrantes et les moyens de les éviter, au nom de la Commission du Radium. British Academy of Medicine (Paris). 1921;85:651–60, séance du 7 juin, at 651: “Les dangers bien connus des corps radioactifs et des rayons X ont attiré depuis quelque temps d'une manière spéciale l'attention du grand public, et ont provoqué des craintes injustifiées.” See also the retrospective account of the 1921 events in Bouchacourt and Morel-Kahn (les docteurs), De quelques point fondamentaux concernant la protection des personnes utilisant les R. X. Bulletin of the Society of Radiology and Medicine (Paris). 1928 Feb 14;16:59–65.

  60. 60.

    Haret, in the discussion, ibid., at 160: “cette observation est peut-être vraie pour son service, mais elle ne peut-être généralisée, sans preuve à l'appui, sous peine de décourager les jeunes radiologistes.” Béclère added: “Nous pouvons tous un jour ou l'autre être atteints d'une affection grave sans qu'il soit absolument besoin de mettre en cause les rayons de Röntgen. Il ne s'ensuit pas, d'ailleurs, que nous ne devions pas nous entourer du maximum de tous les moyens de protection.”

  61. 61.

    Bordier H (le docteur, professeur agrégé à la Faculté de Médecine de Lyon). Sur un cas d’anémie mortelle due aux rayons X. Bulletin of the Society of Radiology and Medicine (Paris). 1921 Nov 8;9:158–60, with discussion.

  62. 62.

    Laquerrière, note 2.

  63. 63.

    See Regaud C. Sur les dangers du radium. Bulletin of the Academy of Medicine (Paris). 1921;85:608–12, séance du 24 mai, where Regaud argued against the lead protection surrounding patients undergoing radium treatments suggested by Bordier H (Professeur à la Faculté de médecine de Lyon). Dangers du radium et mesures à prendre pour les éviter. ibid. 512–13, séance du 26 avril.

  64. 64.

    For mention of the extension of the French law on workmen’s compensation to occupational diseases, see Flaskamp W (Dr. med., aus der Universitäts-Frauenklinik Erlangen). Röntgenschädigungen als Unfälle und Gewerbekrankheiten. Fortschr Röntgenstr. 1924;32:641–7. For the concern with being classified among the “industries insalubres,” see A. Broca, note 59, at 654.

  65. 65.

    For the first recommendations of the British X-ray and Radium Protection Committee, dated June 1921, see Journal of the Röntgen Society. 1921 Jul;17:100–3. For the report of the French commission, see Broca, note 59. The British committee had ten members, including the chairman and honorary secretaries, of whom only three appear to have been nonphysicians (two physicists and one X-ray tube manufacturer). The French committee had five members, all presumably physicians since it was appointed by the Academy of Medicine.

  66. 66.

    Journal of the Röntgen Society. 1921;17:99.

  67. 67.

    Felix A (Institut de Radium de l'Université de Paris). Dispositifs de protection contre les rayons du radium, à l’usage des radiumologistes-manipulateurs. Journal of Radiology and Electrology. 1921 Feb;6:61–6.

  68. 68.

    See the report, note 65, at 100: “The danger of over exposure to X-rays and radium can be avoided by the provision of efficient protection and suitable working conditions…”

  69. 69.

    Broca, note 59, at 654: “…il y a, comme partout, un seuil. Nous sommes certains de l'existence de ce seuil, car il y a souvent, peut-être toujours, de l'émanation dans l'air que nous respirons, en particulier au voisinage de certaines sources minérales, et ces contrées sont habitées par des populations florissantes; beaucoup de malades même y vont rétablir leur santé.”

  70. 70.

    Ibid., at 657: “Il y a certainement un seuil d'action pour les radiations pénétrantes, comme pour toutes les formes d'énergie, et cette vue de l'esprit est confirmée par le fait que nous vivons constamment dans une radiation pénétrante très faible…”

  71. 71.

    Ibid., at 659: “Il n'y a pas lieu, en effet, pour assurer la protection, de réaliser la suppression complète des radiations pénétrantes; il suffit de les amener au-dessous du seuil d'action nocive, et cela est aisé.”

  72. 72.

    Pfahler GE. Protection in Radiology, Presidential Address, read at the 7th Annual Meeting of the American Radium Society, St. Louis Missouri. American Journal of Roentgenology. 1922 May 22;9:803–8.

  73. 73.

    Pfahler GE. The Effects of the X-rays and Radium on the Blood and General Health of Radiologists, read at the 23rd Annual Meeting of the American Röntgen Ray Society, American Journal of Roentgenology. 1922 Sep 12;9:647–56, discussion at 771–74.

  74. 74.

    For reports on the electrocution of Dr. Auguste Jaugeas at Beclere’s X-ray clinic, see Electrocution of a Radiologist. Archives of Radiology and Electrotherapy. 1919;24:267–9, and American Journal of Roentgenology. 1921;7:167–8. For the creation of the Safety Committee,

    see American Journal of Roentgenology, 8 (1921) 204, and for its report on electrical dangers, delayed by the death of its chairman, see “Report of the Safety Committee,” presented at the Los Angeles meeting of the American Röntgen Ray Society, American Journal of Roentgenology, 10 (1923) 246–47. I have been unable to find the Safety Committee’s first report (1923) on X-ray protection, but for a follow-up report see Report of the Safety Committee of the American Röntgen Ray Society presented at the 25th Annual Meeting of the American Röntgen Ray Society, Swampscott, Massachusetts. American Journal of Roentgenology. 1924 Sep 3;12:566–71. All of the members are mistakenly identified there as M. D.’s, but at least two (William D. Coolidge and William Duane) were physicists and not physicians.

  75. 75.

    Williams RC. Preliminary Note on Observation Made on Physical Condition of Persons Engaged in Measuring Radium Preparations. Public Health Reports. 1923 Sep 21;38:3007–28.

  76. 76.

    Amundsen P. Blood Anomalies in Radiologists and in Persons Employed in Radiological Service. Acta Radiologica. 1924;3:1–7.

  77. 77.

    Kaye, note 53.

  78. 78.

    Groede (Frankfurt a. M.-Bad Nauheim). Einleitung. Sammelreferat über Röntgenschädigungen. Verh Deut Ront Ges. 1922;13:75. The survey was to be conducted by the Sonderausschuss für die Beurteilung von Röntgenschädigungen und zurn Studium ihrer Verhütung.

  79. 79.

    Levy-Dorn M (Prof. Dr., Vorsitzendem des Sonderausschusses für die Beurteilungen von Röntgenschädigungen und zum Studium ihrer Verhütung). Leitsätze für das Arbeiten mit Röntgenstrahlen gemäss Beschluss der Deutschen Röntgengesellschaft vom 28 April 1924. Deut Zeit Ges Gericht Med. 1924;4:288–9.

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    Daniel Serwer

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Serwer, D. (2024). X-Ray Measurements and Radium Protection Catch Up, 1914–22. In: Strengthening International Regimes. Palgrave Studies in International Relations. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-031-53724-0_5

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