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2-1 Radium
inum tubes in use. These tubes have their stoppers screwed and goldsoldered,
and in view of the many losses of radium which have occurred
during this procedure, a word of caution may be uttered in this respect.
The soldering necessitates the temperature of the oxy-hydrogen blowpipe.
and notwithstanding that the main length of the tube is cooled
in water, the crimson flame coloration of the radium spectrum is sometimes
seen. Radium sulphate is considered to be a particularly nonvolatile
body, and it must be assumed that organic material, either dust
or i>ossibly traces of oil left from the boring of the platinum tube, have
reduced the sulphate to sulphide. However, if precautions are taken,
and. in addition, all moisture excluded during the filling of th; tube, the
operation of soldering can be carried out satisfactorily.
The opinion is expressed that the future construction of all applicators,
either flat applicators or tube applicators, will be based mainly
on the extend e use of unit tubes with an activity of t to 5 milligrammes
of radium element, constructed of thin-walled rustless steel, nickel, or
even brass, and distributed according to the need of the moment.
In conclusion, grants of emanation have been made for lecture purposes,
and demonstrations of the apparatus used at the Institute can be
given u|K>n application.
THE TECHNIQUE OF RADIATION THERAPY OF
ESOPHAGEAL CARCINOMA*
By James T. Cask. M. D.. F. A. C. S.. Battle Creek. Michigan.
In few situations does a malignant lesion present greater difficulties
in the technique of radiation application and dosage, or less probability
of completely destroying the neoplastic tissue than in carcinoma of the
esophagus. I'nfortunately, the attention of the patient is not drawn to
his trouble until dysphagia appears: and this is therefore the earliest
clinical symptom, usually the one which brings the patient to the physician.
Vet esophageal carcinoma furnishes a large proportion of erroneous
diagnosi- or failure to diagnose, owing to the absence of the symptom
of dysphagia. This was shown in the statistics published some years
ago by Richard Cabot, after reviewing the incorrect diagnoses in a large
series of cases at the Ma»achusctts General Hospital.
Koentgenobgically. the earliest sign of esophageal carcinoma may
be due to the obstruction of constant grade one would expect from the
organic stenosis attending the malignant lesion. The writer has found
many cases of esophageal carcinoma where the firstsigns of obstruction
were apparent long before there existed any actual narrowing of the
esophageal lumen, the hindrance being due to a spasm set up at the level
of the early malignant lesion, or just above it. a considerable time before
the infiltrating process had brought about actual stenosis. This is especially
true of those cases of carcinoma of the lesser curvature high up in
the stomach involving the cardiac orifice. It often happens that these
obstructions are at firstconsidered spastic because the administration of
antispasmodics temporarily relieves the dysphagia. Occasionally an extracsophageal
malignant mass will be accompanied by a spasmodic ohstruc-
• Reprinted by permission from the American Journal of Roeu teen alow «•>•(
Radium Therapy, x. S59-S66. November 1?.'3. Read at the Eighth Annual \I*,.!inof
The American Radium Society. San Francisco. Calif., June 25-26. 1933. """*•