The X-ray: providing a new perspective in 1895

This first form of noninvasive imaging was an instant success in medical diagnostics and beyond.

Issue: September 2008

The 19th century was a time of great discovery and life-changing inventions. During the second half of the century alone, people were introduced to the light bulb, vacuum cleaner, automobile, phonograph, radio and the airplane. A new era of communication made the transfer of information easier and faster than ever, and very few medical breakthroughs benefited more from this boom of communication than the X-ray.

Named “X” because of the unexplainable nature of this form of radiation, the X-ray is still widely used in many industries. Its offspring such as computed tomography, magnetic resonance imaging and positron emission tomography are gaining in popularity and usefulness with each year.

A new type of ‘ray’

William Röntgen was a professor of physics at the University of Würzburg, Germany, when he made his great discovery more than 100 years ago. A weekend of experiments with cathode rays and Crookes tubes produced the discovery of a new type of “ray.” Rontgen was conducting an experiment in which he completely covered a Crookes tube with cardboard to block out all light. He planned to pass current through the tube and look for fluorescence on a barium platinocyanide-coated screen to prove that cathode rays were fluorescent. However, during the experiment he noticed a shimmering on a nearby bench. He then proved that this fluorescence was produced even at a distance from the Crookes tube, meaning that something much more penetrating than the cathode rays in the tube were producing the fluorescence.

On Nov. 8, 1895, the “X” ray was discovered.

That same weekend Röntgen continued to carry out experiments with his new ray. He managed to pass the ray through not only glass but also other materials, including several metals. He also deduced that a thin sheet of lead blocked these rays. During the course of these experiments his hand was caught in the rays. The resulting image showed distinguishable outlines where Röntgen’s bones were.

On Dec. 22, 1895, Röntgen took a radiograph of his wife’s hand using his new ray. This image of a left hand, with a ring visible on the ring finger, is the first documented X-ray.

Spreading the news

The first X-ray image taken in 1895 of William Röntgen’s wife’s left hand and shows her ring.

Photo courtesy of the National Library of Medicine

In late December 1895, Röntgen submitted a manuscript titled “On a New Kind of Rays” to the Physikalisch- Medizinische Gesellschaft, a little known, non–peer-reviewed medical journal. Röntgen then sent a few early copies of the paper to scientific colleagues at the beginning of 1896. One of them ended up in the hands of a young physicist whose father edited the Die Presse in Vienna. This young man wrote an article on the discovery that appeared in the paper on Jan. 5, 1896, noting that a “surgeon could then determine the extent of a complicated bone fracture without the manual examination which is so painful to the patient.”

From there, the news of this new discovery spread like fire. London newspapers were publishing information about the discovery within a day, and the news had jumped the pond to North America by January 9. Röntgen was not scheduled to present the manuscript until January 23.

Although some scientists reported having witnessed similar phenomena when working with cathode rays, none had been able to understand their significance. Now that it had been documented, scientists were able to reproduce Röntgen’s experiment using the same materials he had. Furthermore, the X-ray was almost immediately applied to medical procedures.

Within three weeks of Röntgen’s announcement, Edwin and Gilman Frost used the X-ray at Dartmouth College to produce an image of the left forearm of a boy who had fallen while ice skating. In early February, a professor at McGill University used the procedure to locate a bullet lodged between a patient’s tibia and fibula. In Great Britain, doctors used it to locate a needle that was embedded in a woman’s hand. The print was given to the surgeon the next day to help in the removal of the needle. Within a year the X-ray was being transformed and adapted to different uses. X-ray images were used as evidence in legal cases, to help maintain quality control in the manufacturing of metal products, to detect fraudulent documents and more.

Röntgen chose not to capitalize on his discovery and frequently turned down awards, honorary memberships and medals offered to him because of it. However, Röntgen was nominated for and won the first Nobel Prize in physics awarded in 1901. He did travel to Stockholm to accept this award but did not give an official acceptance speech.

After effects

The toxicities of radiation exposure were noted shortly after the dissemination of the discovery. Early X-rays required long exposure times leaving patients exposed to radiation for as many as 80 minutes per X-ray. Even worse, the early radiologists and X-ray workers were exposed on a daily basis. A British physician who is credited with the first clinical X-ray in England developed cancer of the hands.

Thomas Edison conducted a lot of early research with X-rays. His assistant Clarence Dally had hair loss and skin ulcers, which eventually developed into carcinoma of the hands. He had both arms amputated and died of recurrent carcinoma in 1904. This same fate would befall many of the people involved in research or experimentation with X-rays, except for the discoverer, Röntgen. Röntgen conducted his experiments in a lead-lined zinc box, protecting himself from large amounts of exposure.

Measures soon were adapted to prevent radiation exposure, and the popularity of the X-ray in medicine and beyond has continued to grow. Early growth was partially fueled by the use of the X-ray to help diagnose and detect tuberculosis, the leading cause of death in the last half of the 19th century. In 1946, six million diagnostic X-rays were taken during public health screenings. By 1950 the number had more than doubled to 15 million. Numbers for 1990 were up to about 260 to 330 million radiologic procedures. – by Leah Lawrence

For more information:

GE Healthcare. W.C. Roentgen and the discovery of X-rays. GE Medcyclopaedia Textbook of Radiology website: www.medcyclopaedia.com/library/radiology.

Lentle B, Aldrich J. Radiological sciences, past and present. Lancet. 1997;350:280-285.

Spiegel PK. The first clinical x-ray made in America — 100 years. AJR. 1995;164:241-243.