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R a d i u m
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mal 7 days later. Abdominal examination elicited that the pelvis and
lower abdomen were filled with a hard exudate, which continued for a
period of 3 months, slowly subsiding without further symptoms. At the
present time this patient is in excellent general health, free from pain.
foul or bloody discharge. The disease, however, is slowly extending
along the posterior vaginal wall.
The fourth case with a disastrous reaction, was due to streptococcus
haemolyticus. The patient was a Russian of 42 years. She gave a false
history. Our clinical diagnosis was chronic metritis, and she was subjected
to a curettage and 1200 milligram hours of radium. The true
history was that she had an induced abortion a few weeks previous to
admission. Her convalescence was uneventful for 5 days, then her temperature
rose to 104, with a pulse of 120, and she complained of painful
areas over the veins of her legs, and painful wrisls. She appeared very
ill. Leucocyte count was 5:00. .villi 83 per cent polymorphonuclears.
Blood culture showed streptococcus haemolyticus. Death occurred 6
days after the onset of the fever.
SUMMARY
My impressions are that—
1. Radium, heavily screened with one millimeter of platinum and
2 millimeters of rubber and used within the uterus in 1200 to 2400 milligram
hour doses, even with repeated administrations, causes no unto
ward effect on bladder and rectum and produces very little troublesome
leucorrhcea. If the radium is used within the vagina without careful
proteclion of bladder and rectum, it will cause a reaction; but not nearly
so disastrous as would be Ihe case if ji-rays were used.
2. The temperature reactions occasionally seen are more likely to
be due to a fresh invasion by organism started by the curetting and
blocked drainage than to radium.
3. Radium alone is an excellent treatment for chronic metritis and
small fibroids at the menopause age, curing most of the cases with one
1200 milligram hour dose, but even a 2400 milligram hour dose will not
always control the bleeding indefinitely in all patients.
4. Plastic operations on cervix and perineum may be performed
with excellent results at the same time that radium is applied to the
interior of the uterus.
5. For advanced cases of cancer of the cervix and corpus, radium.
as a palliative measure, gives more relief than any other treatment at
our command.
6. In early cervical cancers, the Byrne cautery operation, and
radium at ihe same session, with or without X-ray treatment later, give
results which are so valuable ihat it should be thoughtfully considered as
a possible standard method of treatment.
7. It it is impossible lo forecast how much or how little radium
treatment will accomplish for any particular patient suffering from carcinoma.
I am Indebted to all the members of ou. staff for the privilege of reportinc on
their cases which have been treated with radium.