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66 R a d i u m MR. ALBERT R. RAYMER President Standard Chemical Company, Pittsburgh, Pa.
R a d i u m e? CONTRAINDICATIONS TO THE USE OF RADIUM IN GYNECOLOGY* By William P. Graves. M. D.. Boston, Mass. In the enthusiasm that follows the advent of so brilliant a remedy as radium there is danger of overestimating its field of usefulness and of regarding too little its possibilities of doing harm. The purpose of this paper is to emphasize certain dangers with which the use of radium is attended in gynecological practice and to discuss its indications and contraindications in various conditions in regard to which there is at present a division of opinion. The particular dangers of radium in gynecologic cases, are only loo familiar lo those experienced in its use. These dangers have been lo some extent brought to the attention of the general profession, but are almost unknown to the laity who, deriving their information from unreliable sources, see in radium only a miraculous and harmless remedial agent. A clear realization of the dangers of radium is of greatest importance to those who arc employing it as beginners, of whom there is at present a large and rapidly increasing class. Where radium is owned by hospitals it has been, as a rule, assigned to selected members of the staff, many of whom have wisely taken a preliminary course of instruction in its use. Under such conditions comparatively little harm has been done, treatment having been given by men who possess a competent clinical knowledge of the diseases with which they are dealing. In view, however, of the great increase in private ownership of radium. and of the institution of distributing centers from which radium emanations may be secured., there is cause for fear that its use may become too indiscriminate and productive of harm. It is not in any sense the desire of the writer to discourage the wide distribution of a remedy so beneficial to mankind as radium, but merely to aid in calling attention to both physician and patient that radium is a powerful agent with destructive properties that are capable of serious or even fatal results. The misuse of radium has not so far as I know led to any definite legal regulations, hut such an event is certainly within the range of possibility. In order to avoid restrictions that might be undesirable it is necessary that those who are employing radium should exercise the greatest caution in its application and should be frank in reporting evil as well as good results. The practitioner who is contemplating the treatment of patients with radium should thoroughly realize at the start that the most complete knowledge of the physical properties of radium and the most elaborate equipment do not justify him"in treating diseases with which he is not clinically perfectly familiar. He should realize, for example, that cancer is not a distinct* disease by itself which is subject to standaradized methods of treatment; but that it is merely a generic term to define malignant changes that take place in many different tissues. Cancer •Reorinted by permission from The American Journal of Obstetrics and Gynecology i>c. 445-452; 561-56G; April, 19Z5. Read (by invitation) at a meeting of the Obstetrical Society of Philadelphia. May 1. 1024.
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PRESENTED BY PUBLISHER
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CONTENTS OF VOLUME THREE. NEW SERIE
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F. W. Aston, D.Sc, F.R.S. Atoms and
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2 Radium P. M. the apparatus is app
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Radium value of the metal container
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Radium Table I—Continued Classifi
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8 RADIUM The affections of the thyr
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10 R a d i u m The treatment should
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12 Rapitjm ooo per cubic millimetre
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14 Radium tines of tubercle bacilli
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16 R A D I U M 4. Lymphatic Leukaem
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18 RADIUM than in anv other organs
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20 R a d i u m In a previous paper
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99 Radium 2 mm. thick; the whole ap
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2-1 Radium inum tubes in use. These
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26 R a d i u m 5-gr. capsule and sw
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28 R A D I U M 1 tared, as in the f
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80 R a d i u m (6) The greatly less
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32 R a d i u m and at times three,
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04 R a d i u m capsule is placed un
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36 R a d i u m 1 have observed one
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38 R A D I U M Frequency and Distri
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10 R a d i u m holder with comparat
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42 HADITJ M gestion of the eve whic
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44 R a d i u m The low polymorphonu
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46 Radium examined, it is believed
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48 I^ADITJM Positive results of exp
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50 R a d i u m 1 Is e III , -m If "
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»2 R a d i u m The summary of phys
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Radium 55
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R a d i u m 57 s V. — •7 CO N
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R a d i u m 59 Measuring radium by
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R a d i u m 6i Bibliography I. Gudz
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R a d i u m 68 Ited cells, SUBJECT
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R a d i u m TECHNIQUE OF RADIUM TRE
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R a d i u m B7 INDEX OF ARTICLES RE
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R a d i u m 69 Bower, J. O. and Cla
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R a d i u m 71 —Treatment of mali
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R a d i u m 73 —Carcinoma of oeso
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R a d i u m 75 —Uses of radium in
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R a d i u m 77 Kimbrough. J. B. and
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R a d i u m 7^ Lymph Nodes—Histol
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R a d i u m si Nicolich—Carcinoma
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R a d i u m 83 Radium— —Large d
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a d i u m 85 -Physical conditions o
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R a d i u m ST Arch. f. Gynak. 118:
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R a d i u m 89 Scholten, G. C. J.
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R a d i u m 91 (A. J. Larkin) Am. J
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R a d i u m 93 —Xecessity for com
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RADIUM 95 Wallerstein, E. U.—X-ra
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A QUARTERLY JOURNAL DEVOTED TO THE
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R a d i u m 99 casionally a carcino
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R a d i u m 101 would be detected w
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R a d i u m 103 cially likely if th
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R A D I U M 105 radium irradiations
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R a d i u m 107 that in nearly ever
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R a d i u m 109 liver and lung meta
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Radium in Appleton Co., 1922. (2) P
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R a d i u m 113 BLOCKING LYMPHATICS
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R a d i u m 115 removed, and the ra
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R a d i u m in PATHOLOGY Pathologic
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4. Cauhape: Thesis. Paris. 1911. R
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R a d i u m 121 is necessary by thi
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Radium 123 is injected into the tis
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R a d i u m 125 (3) Polonaise Numbe
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R a d i u m 127 modern laboratories
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R a d i u m 129 NINTH ANNUAL MEETIN
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R a d i u m 131 Several distinguish
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R a d i u m 133 which X-rays or rad
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R A D I U M 135 In the autobiograph
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R A D I U M 137 of radical operatio
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R a d i u m 139 reports 26 cases, 8
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R a d i u m 141 George W. Crile, M.
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R a d i u m 143 "In carcinoma of th
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R a d i u m 145 " 1 he principal ob
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IUM 147 have found no means of obvi
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R a d i u m 149 and six hours. Now
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R a d i u m 151 thoroughly transfix
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R a d i u m 153 weakness, palpitati
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R a d i u m 155 had all been benefi
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R a d i u m i57 tation of the kidne
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Radium 159 Can walk only with a can
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R a d i u m 163 in operative clinic
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a d i u m 165 In Table II we have d
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Hajmu.m 167 tery was used in combin
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R a d i u m 169 TABLE IX.—RESULTS
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R a d i u m m Radium alone Class i.
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R a d i u m 173 and papillary carci
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R a d i u m 175 It grows rapidly, i
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R a d i u m 177 emanation tubes. Th
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R a d i u m 179 never at any time f
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R a d i u m 181 THE TREATMENT OF MA
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R a d i u m 183 Cast 3. Carcinoma a
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R a d i u m 185 Chm 7. Showing cond
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R a d i u m 187 courting disaster b
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R a d i u m 189 radium in the treat
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R a d i u m 191 Histologic changes
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R a d i u m 193 about their involut
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R a d i u m 195 due to x-ray, sunli
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R a d i u m 197 zation of a partial
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R a d i u m 199 to report his cases
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201 very often will result in a dec
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R a d i u m 203 the cautious use of
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IUM 205 On Jan. 14th. which was a v
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CONCLUSIONS 207 That in some cases
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R a d i u m 209 (b) The fluorescent
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R a d i u m •, 211 patient. The p
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R a d i u m 213 radiological depart
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R a d i u m 215 fortunately, the im
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R a d i u m 217 know whether such c
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R a d i u m 219 eight months had el
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R a d i u m 221 "The selective and
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R a d i u m 223 of a simple unitary
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R a d i u m 227 in their beta ray a
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R a d i u m 229 or the gradation of
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R a d i u m 231 be left in malignan
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R a d i u m 233 during repeated cau
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R a d i u m 235 3. The presence of
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R a d i u m 237 situated at the lim
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R a d i u m 239 REFERENCES 1. Wickh
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Rajpium 241 the test of five years,
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R a d i u m 243 comparative statist
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R a d i u m 245 end results of 201
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R a d i u m 247 Operation Hysterect
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R a d i u m 'IV.) and five years, a
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R a d i u m 251 or effect upon, the
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R a d i u m 253 2. Early Cases.—T
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R a d i u m 255 groups: the superfi
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R a d i u m 257 "I am becoming more
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R a d i u m 259 ment of 'Radiumhemm
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R a d i u m 261 unusual symptoms an
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R a d i u m 263 dition continued sa
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R a d i u m 265 died from hemorrhag
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R a d i u m 267 equals 132 millicur
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R a d i u m 269 "The data in the li
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R a d i u m 271 animals a diminutio
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R a d i u m 273 rays as contrasted
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R a d i u m 275 depression than a d
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R a d i u m 277 repeated operations
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R a d i u m 279 tonsil completely,
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Radium 281 Ihe tonsil is dangerous
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R a d i u m 283 WILLIAM H. B. AIKIN
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DEVOTED TO THE CHEMISTRY, PHYSICS A
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PUBLISHED SEMI-ANNUALLY AND DEVOTED
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R a d i u m 3 ORAL CANCER The next
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lymph nodes in even case, but when
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adiation up to 2400 milligram hours
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R a d i u m o radium to relieve pat
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R a d i u m 11 Uterine Fibroids The
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R a d i u m i3 by some operators. X
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Page 311 and 312: R a d i u m n tions, the distance s
Page 313 and 314: R a d i u m 19 APPENDIX RADIUM AND
Page 315 and 316: Radium 21 BASIC AND CONTBIBUTING FA
Page 317 and 318: RA.PIUM 23 X-RAY AND RADIUM THERAPY
Page 319 and 320: R a d i u m 25 Since, by the impact
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Page 323 and 324: R a d i u m 29 In other cases the g
Page 325 and 326: R a d i u m 31 The recital of this
Page 327 and 328: R a d i u m 33 index of articles re
Page 329 and 330: R a d i u m 35 Block, F. B., and Cl
Page 331 and 332: R a d i u m ?,- J. R. Ranson) Color
Page 333 and 334: R a d i u m :;:» —Epithelioma of
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Page 337 and 338: R a d i u m 43 Hot Springs, Arkansa
Page 339 and 340: R a d i u m 45 Lee. B. J., and Here
Page 341 and 342: R a d i u m 47 Mineral Waters, exam
Page 343 and 344: R a d i u m 49 —Treatment of inop
Page 345 and 346: R a d i u m 51 - Metabolic changes
Page 347 and 348: R a d i u m 58 Radium, emanation—
Page 349 and 350: R a d i u m .>.) —Physiological a
Page 351 and 352: R a d i u m 57 —Experimental rese
Page 353 and 354: R a d i u m 59 Spleen, physiology
Page 355 and 356: R a d i u m 6l —Animal tumor cell
Page 357 and 358: R a d i u m es —Treatment of uter
Page 359: PUBLISHED SEMI-ANNUALLY AND DEVOTED
Page 363 and 364: R a d i u m 69 in addition to the i
Page 365 and 366: Radium 71 the most common, in the o
Page 367 and 368: R a d i u m ?:; nexae is a positive
Page 369 and 370: R a d i u m 76 essential to success
Page 371 and 372: R a d i u m 77 Our technique is to
Page 373 and 374: carcinoma of the CERVIX R a d i u m
Page 375 and 376: R a d i u m 81 a bleeding, cauliflo
Page 377 and 378: R a d i u m HS Fibrinous patch on e
Page 379 and 380: R a d i u m sr, mal 7 days later. A
Page 381 and 382: R a d i u m ST idly develops and me
Page 383 and 384: R a d i u m 89 2. Cervical cancer o
Page 385 and 386: R a d i u m 91 irradiation treatmen
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Page 389 and 390: R a d i u m 96 parenchyma eventuall
Page 391 and 392: R a d i u m 97 ihe lowest (2) was t
Page 393 and 394: R a d i u m 99 3. The treatment int
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Page 397 and 398: a d i u m 103 Sloughy Not sloughy .
Page 399 and 400: R a d i u m 105 But 2 of 15 cases h
Page 401 and 402: R a d i u m 107 Sice (not of tumor,
Page 403 and 404: IUM 109 Time well Number of cases i
Page 405 and 406: R a d i u m 111 died of a secondary
Page 407 and 408: R a d i u m 113 epithelioma of the
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R a d i u m 117 as held by many wri
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R a d i u m 119 of foods, particula
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R a d i u m 121 which, in the last
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R a d i u m 123 "It has long been r
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R a d i u m 125 OBITUARY JAMES C. G
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