In the presentation of a paper dealing with physical therapy technique, in which light we may justly regard Roentgen therapy, I feel that it is advisable, and indeed imperative, to point out the underlying physics substantiating the method employed. This point becomes of even greater importance and significance when presenting a scientific explanation of treatment to replace the heretofore mechanical method of attack.
The older methods of Roentgen therapy, though in many cases beneficial were, in their mode of action, purely mechanical and could often have been substituted by the cheap and most effective applications of the cherry-red soldering iron, for the ultimate goal in the past has been the destruction of the mass by the rays; often accompanied by undesirable, uncontrollable and fatal reactions.
Every Roentgenologist has experienced beneficial therapeutic results following a “sub-lethal” dose of Roentgen rays; and he has likewise experienced unexplained responses to Roentgen therapy. These two points alone must satisfy the thinking therapeutist that there is another action of the rays aside from that of destruction.
I think that there are few of us who are acquainted with the underlying bio-physics of cell metabolism, therefore few of us have attempted to apply the physics of ray generation and action to the existing physics or bio-physics of the body cell, but the day is now at hand when we as Roentgenologists, are called upon to view our problem in a truly scientific light and to utilize the knowledge of present day advances in the sciences of physics and chemistry; and when we do, we find them fitting in admirably.
It is impossible, in a presentation of this nature, and extent, to give more than a very brief glance into the complex physical foundation underlying our method of Roentgen therapy, however, the citing of a few basic facts of physics and physical chemistry will satisfy you with the rationality of the procedure.
Let us start with the cornerstone upon which this structure is rapidly being built.
The cornerstone is the atom, the basis of all matter; organic and inorganic, animate or inanimate. We cannot conceive of anything “under the sun” without dealing with this ultra- microscopic division of matter; all of us mortals being “under the sun” naturally come under the consideration of atomic structure, mechanism and energy, so let us proceed to briefly outline some points regarding this physical unit of anatomy and physiology.
Every atom, known to the present day scientist, is composed of two component parts; one a positive particle, named by Rutherford a proton; the other, a negative portion, or electron. These two components are endowed with equal quantity of electricity, but of course, opposite in sign.
Every atom is electrically neutral, that is, is composed of equal charge of positive and negative electricity, otherwise there would be no atoms. When an atom loses its electrical equilibrium it is termed an ion. There are, of course, two forms of ions; one, in which the atom has been deprived of an electron, and therefore termed a positive ion, with one elementary quantum of electricity; the other, in which an electron has been added, causing the formerly neutral atom to become a negative ion, with one elementary quantum of electricity.
Now, if we know that our body cells are nothing more or less than a mass of chemical substances, and that all chemical substances are merely chemical molecules massed together, and that these molecules are aggregates of ions, and that these ions are merely atoms which have been altered by the loss or addition of electrons, and are therefore electrically charged, we MUST view our bodies as a huge, functioning mass of electrically charged particles, or in brief, a mass of functioning electricity. This scheme naturally only applied to the living body, for it is quite likely that in due time after death, such functions are brought to a state of balance, but it is not until this balance of electrical units is brought about, that we can speak of death in the true sense of the term.
From the above reasoning, we must regard each and every function of our bodies as an electrical reaction. No matter how obscure the function is (such as the division of cells, which always follows a well defined routine) and apparently complies with the law formulated by Du. Fay in 1733, i. e., like electricities repel, unlike attack; or how pronounced it may be (muscular contraction, nerve impulse, etc.) its mode of action is unquestionably governed by physical, electrical, or physical- chemical forces.
There is such a vast number of phenomena illustrating this point that it will be only possible to cite a few examples. However, allow me to say, that with continued work in this field of research, so many facts and explanations are brought to light, that the investigator is bewildered with its great magnitude of usefulness. Indeed, life itself, may receive explanation upon the principle underlying the facts herewith presented.
In our researches, we have considered the changes taking place within the unit cell rather tan the gross pathology of neoplasia; therefore, in this report we will consider unit cell alteration during and accompanying tumor formation, and the action of rays upon it. It is quite evident that any pathologic condition is characterized by the arrangement of the cells and their relationship to definite histological landmarks. That for any alteration of the arrangement of the cells, the cells must first, within themselves be altered. This means that the molecules and atoms comprising the cell metabolism must suffer the initial alteration.
The normal, resting, and adult cell, consists primarily of two distinct parts –a nucleus and cytoplasm; the former of which is electro-positive as compared to the latter. This holds true with all forms of cells known to the present time.
Now, if we consider a cell, stripped of cytoplasm and therefore consisting of nuclear material alone (such as the sperm head, or bacilli) we can see that any influence brought to bear by such an agent, acts through the influence of its electro-positive properties alone, this needs no elaboration.
Such a condition exists in a process, similar in many details, to that manifested in tumor formation; that is, in the fertilization of the ovum. Here we have an ovum, a physically balanced cell, consisting of nucleus and cytoplasm; stimulated to reproduction by the addition of the sperm head (an electro- positive agent). The process of fertilization and cytogenesis is accompanied by a far greater cell reproduction than are the ravaging processes of malignancy, but there is unquestionably a difference between the “embryonal” and the “cancer” cell.
Investigators in the field of oncology demand that any method of experimentation or therapy adaptable to the characteristics of neoplasia, must also apply to embryonal tissue.
With this in mind we have, at the present time, under way an extensive investigation on embryonal tissue reactions, which work will later be checked by the substitution of neoplastic tissue.
In the comparatively short time this work has been under way, the results offer, to date, very interesting and gratifying data which will, we believe, greatly extend our knowledge of the nature and successful combating of malignancy. However, a detailed report of this investigation will not be released until such time that every possible phase and complication of it has received thorough study, and has been checked and re-checked to the satisfaction of the investigator. The special apparatus designed and made for this work will be shown and explained by means of a lantern slide.
We have had pointed out the similarity between embryonal and neoplastic tissues, and have been told of the one and only factor responsible for the evolution of the former. This leads us to suppose that electro-positive agents are responsible for stimulated cell reproduction; and this being the case, the cells once stimulated are themselves electro-positive as compared to normal, resting, and adult cells; the reasoning is self evident and needs no further elaboration.
We further know that the more embryonal the nature of the cells comprising malignant neoplasms, the more rapid and fatal the prognosis. This suggests that the more electro-positive a cell, the greater is its capacity and power of reproduction.
Now, let us get down to the point as quickly as possible.
My colleague, Butts, has found, in an extensive investigation of the physical or physico-chemical phenomena of tissues, that neoplastic tissue possesses a greater or higher potential than does normal tissue; or, in other words, is electro-positive as compared to normal cells of the same structures. This phenomenon is likewise displayed by embryonal tissue but, as we would naturally expect, to a greater degree.
Perhaps you may wonder where the connection exists between the cells comprising our bodies and the atoms, to which I previously referred.
We have been told that the atom consists of positive and negative particles. Likewise, the body cell is built up of positive and negative portions. In both the neutral atom and the normal body cell, there is enough of positive and negative portions to hold the systems in a state of balance and equilibrium.
I have mentioned the fact that an atom, losing or gaining an electron, is altered so as to become a positive or negative ion. I have told you that a body cell, deprived of some of its electro-negative portions, becomes an electro-positive cell; in other words, a pathologic cell, with an altered “habit- chemistry”; and disturbed physico-chemical balance. This point will be made clear by na lantern slide.
Analysis of the rays and radiations from radioactive sources and the Roentgen tube, demonstrates the discharge of three forms of radiation; namely, alpha, beta, and gamma. The former two alone being electrically charged, whereas the last are energy waves, or electro-magnetic vibrations of the ether.
The alpha particles, or rays so-called, although of positive nature, may be disregarded as entering into the problem of therapy, due to their low penetrating power.
The beta particles are electrons, charged with negative electricity. They are the units of negative electricity. These are the units upon which our radium and Roentgen therapy is based. The gamma rays, although not electrically charged, are nevertheless of outstanding importance in the employment of ray therapy, not as previously believed but for their physical properties.
We know from the Theory of Relativity that Matter and Energy are interchangeable. This being the case it is necessary that we have a form of energy to give rise to electron formation when coping with deep-seated pathologies. For this reason the gamma rays from radiation bodies, or the X-ray from the Roentgen tube are of value. Scientific reason and research offer no other reason for their usefulness.
However, if this electron formation is desired at a point other than in the depths a means of ray disorganization had to be developed. This we have done for the treatment of superficial pathologies by interposing between the tube and the lesion a substance of sufficient density to cause the scattering of the primary X-ray beam, and still to be of such density as not to filter out the electrons so formed.
By such a procedure we hoped to supply to the electron deficient tissue sufficient electrons to compensate for those lost during pathologic cell change — a process of construction rather than destruction.
The stimulating effect of rays is readily explained by viewing the cell as a neutral atom, sensitive to the same physical alterations as are the atoms of any substance used in the study of atomic structure.
By this I mean, that atoms exposed to radiation are deprived of some orbital or planetary electrons by the action of the rays, and are thereby rendered positive ions, so with body cell.
The work of Butts has demonstrated that repeated and prolonged exposure to negative electrons is responsible for the gross tissue destruction and sloughing so undesirable in the treatment of malignancy, especially so when such damage is to the normal surrounding structures or when the area to be treated is in close proximity with large vessels, thereby adding the danger of death from haemorrhage.
He has also experimentally demonstrated that small fractional does of beta rays of radium, or corpuscular rays from the Roentgen tube bring about a marked biological cell change, atrophy of the tumor mass, and apparent readjustment to normality and normal “habit chemistry”, about which Dr. Butts has kindly agreed to speak in his discussion.
Analysis of One Hundred Cases Constantly Under Observation to Date.
PRIMARY CARCINOMA (36).
No. cases. Clinically well. Imp. Unimp. Worse. Dead. Unknown.
36 8 18 2 2 5 0.
RECURRENT CARCINOMA (43).
No. cases. Clinically well. Imp. Unimp. Worse. Dead. Unknown.
43 8 21 0 4 9 0.
No. cases. Clinically well. Imp. Unimp. Worse. Dead. Unknown.
14 3 3 1 1 5 0
Prophylaxis 7 (all clinically well).
Total number of cases treated, 183.
Number of cases verified malignant by pathologic section about 75 per cent.
The remaining 83 cases are not reported for the following reasons, either:.
(a) Case too new to report any definite data.
(b) Benign tumors are classified under separate heading, although the results have been extremely gratifying.
(c) All efforts to follow up cases have met with failure. Many of these are, without doubt, clinically free from their original condition as reports prior to their absence were very favorable.