Sunday, March 2, 2014

X-RAY TREATMENT FOR RINGWORM IN 1927 REMINDS US OF RADIATION ABUSES


Nedra and I saw a documentary “Hole in the Head” at the Monroe County Public Library on an act of radiation abuse carried out in 1927.  About 15 children, all African American, from a small town, Lyles Station, in southwest Indiana were taken by bus to the nearby general hospital at Princeton, Indiana.  There each had radiation treatment for ringworm. The children felt ill going home, some vomiting. Their hair fell out and in some grew back in patchy ways.  One, Vertus Hardiman, the subject of the film, had severe burns from the radiation and his scalp never quite healed.  He wore a cap or wig the rest of his life.  Despite this over dose of radiation, Hardiman lived into his mid 80s. He never married. His last three years were painful as bone cancer eroded his cranium leaving a gaping hole into his brain. The author of the documentary, Wilbert Smith, described the procedure used on the children as an experiment, but it is not clear for what purpose it was done or who designed it.  Smith compared it to the syphilis experiments carried out in the South in the 1930s-60s which deceived patients who thought they were being treated for tertiary syphilis.   The unit of measurement, the roentgen, was roughly described (but not named) in 1908 and made international in 1928.  The measurement of dosage for medical purposes was physiological until 1928. The number of seconds of exposure before skin reddened was called a threshold dose (or other names). Treatments were based on multiples of the threshold dose. The Victoreen dosimeter (which I used in Muller’s laboratory) was not invented until 1925 (by Otto Glasser and Hugo Fricke, both in the US) and marketed by Jack Victoreen in Cleveland in 1928.
              The treatment of ringworm by radiation began in 1897 in Germany. It was introduced to the US in 1903. The Kienbok-Adamson method of dividing the scalp into five target regions was proposed in 1907.  A London studied in 1910 claimed “in the hands of experts no danger is incurred.” Dose estimates for treating ringworm vary from 340-660 roentgens.   A 2003 study of 2224 x-rayed children followed for about 39 years contrasted 1380 who were given topical treatments (medications). In the x-ray group there were 16 intracranial tumors, 2 thyroid cancers, and 8 leukemias.  In the topical treated group were 1 intracranial tumor, no thyroid tumors and 1 leukemia.  After 1959 x-ray treatment ceased and was replaced by topical application of an antifungal medicine, griseofulvin.
              Muller had a folder of news clippings which I looked at in the Lilly Library at IU when I wrote his biography.  The abuses of radiation were numerous.  Medical uses included straightening out bow-legs in children, shrinking “enlarged” thymus glands (the alleged cause of chronic respiratory infections), curing plantar warts on the soles of feet, and inducing ovulation in infertile females by 100 r doses of x-rays to the ovaries and pituitary (the Kaplan treatment of the 1920s). Chiropractors at 4H fairs in Indiana had “straightest spine contests” using x-rays.  Shoe stores had fitting of children’s shoes with fluoroscopes.  When I married Nedra in Rochester, Indiana the shoe store on Main Street was called Taylor’s X-Ray Shoe Store.  During WWII those working in shipyards examined steel plate welds for imperfections using x-rays and protection of workers was spotty.

              I don’t know if an experiment was going on Lyles Station, Indiana or what its intent was. What is clear, however, is that abuse of radiation through ignorance, over-confidence, wishful thinking, and incompetence was prevalent in the early history of medicine and radiation abuse still exists because those attitudes are difficult to control.

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