Where did all it begin?

Published: 16 November 2011

New committee member Grace Johnston reports on the early history of x-rays, or ‘shadowgrams’ in the UK and the advent of radiology and radiology nursing as we know it.

Intriguing findings

When I was asked to speak at a conference for retired nurses, I wasn’t quite sure what to present, but after some thought about the audience and discussion with the chair, I settled on ‘Radiology nursing – past, present and future’. When researching for the content, I found the information about the origins of radiology quite intriguing.  I hope you find the following as interesting as I did.

The history

Wilhelm Conrad Roentgen is credited with discovering x-rays on 8 November 1895 at the Physical Institute Laboratory in Wurzburg, Germany. Ironically, he disliked photos being taken of him. Photo 1: X-ray pioneer Wilhelm Conrad Roentgen

Accidental x-ray

On 22 December 1895, Roentgen took an image of his wife’s hand  

This is said to be the true birthday of radiology and radiography as a medical specialty. However, the first radiograph ever taken was in fact taken accidentally, by Arthur Willis Goodspeed at the Physical Institute University of Pennsylvania, USA. Goodspeed and a friend, W N Jennings, were photographing electric sparks and brush discharges on the evening of 22 February 1890. After such experiments, the table was still littered with loaded photo plate holders and other apparatus.

When Goodspeed brought out some Crookes tubes and demonstrated them to Jennings, the next day a very curious phenomenon was found on the developed plates: two round discs superimposed and spark tracings on the photographic plate negative. This couldn’t be explained so they put it to one side with other unusual photographs and it was forgotten about. Six years later in 1896, the plates were re-examined. Another exposure was made under similar conditions and the results were the same. Goodspeed concluded in a lecture on x-rays on 22 February 1896, saying: “We can claim no merit for the discovery, for no discovery was made”.

News of discovery grows

In January 1896, Roentgen sent his paper and photographs of the image to Professor Arthur Shuster in Manchester and Lord Kelvin in Glasgow, two distinguished British physicists. At that time, Lord Kelvin was considered the doyen of European physicists. However, he was ill so it was passed to his brother-in-law Dr Bottomley, who was associated with Lord Blythswood and Dr John MacIntyre, in electrical experiments. These three gave the first demonstration of x-rays to Glasgow’s Philosophical Society on 5 February 1896. On 7 February 1896, an ophthalmologist at Aberdeen Royal Infirmary, James McKenzie Davidson, set up apparatus in his home and consulting rooms in Aberdeen at 343 Union Street.  He was quick to realise the potential of this discovery.

On 15 February 1896, it was reported in the local newspaper, the Aberdeen Journal, that on 14 February, a nine-year-old girl who had had a one-inch portion of a needle in her foot for three days, had become one of the first in Britain to have an operation under x-ray control. The following paragraphs of the article give us an idea of practice at this time:

“A great deal of interest had been aroused, not only in medical circles, but among the general public as the remarkable discovery of a means by which shadowgrams can be taken of objects through substances hitherto considered to be opaque.

“The recent lecture by Dr McKenzie Davidson, Aberdeen, on light and colour has given a fresh interest to the subject, and his illustrations of the capabilities of the new photography have seemed to whet the public appetite for further developments. Dr McKenzie Davidson has been the means of conferring on Aberdeen no small distinction in surgery, which was performed yesterday, as the result of a photograph which he took of the foot of a child which a portion of a needle had penetrated. 

“The child, a girl of nine years of age, who was a patient of Dr Gibb, was taken to the residence of Dr Davidson for the purpose of having the foot photographed, and an operation was subsequently performed. Dr Alex Ogston was present as chloroformist, and Dr Gibb performed the operation. In taking the photograph of the foot, Dr McKenzie Davidson placed a copper wire around the foot of the patient at a certain small measured distance from the punctured wound where the needle was supposed to have entered. After an exposure of forty minutes an excellent shadowgram was obtained, and to the experienced eye of the doctor, who had made numerous previous experiments, the exact position and inclination of the needle were revealed. A measurement was taken from the black line made on the photograph by the copper wire to the portion of the needle nearest the surface of the foot, and Dr Davidson was able to point out the exact spot where the incision should be made. Dr Gibb in a moment found the object, and in less than five minutes the whole operation was over, having been accomplished in the most successful manner.

“This is believed to be among the first practical applications of the new discovery in this country, and Dr McKenzie Davidson has to be congratulated on the success of the experiment, without which it would have been impossible to determine the position of the offending object. The needle had been in the foot for about three days, and was about an inch in length, a small portion at the head, including the “eye”, having been broken off.

“It may be interesting to add that yesterday, a similar operation was performed at the Queen’s Hospital, Birmingham. A fortnight ago a Mrs Berry ran a needle into her hand, and the hand became much swollen. Dr Hall Edwards took a photograph and the needle was clearly seen. The operators have extracted it with the assistance of the print and speak highly of the assistance it has been to them”.

Success! And danger...

James McKenzie Davidson moved to London and became Britain’s leading radiologist in the first decade of the 20th century. His house became a centre for all x-ray activity, a place to which radiologists from all parts of the world journeyed. He was knighted in 1912 for services to medicine – the first and only pioneer radiologist to be so honoured. This award was viewed as much as official recognition of the x-ray profession as a personal award.

This huge advance in patient treatment and diagnosis was not without sacrifices: between 1896 and 1903, 14 British operators died from overexposure. In fact, a memorial in Hamburg to commemorate martyrs to the development of radiology holds the names of 169 radiologists from 15 different countries.

The dangers of X-rays just weren’t known. An example of this was the early experimental work that was carried out by Professor Waymouth Reid, a physiologist in Dundee, and Professor Johannes Kuenen, a physicist. In 1897 Reid subjected himself to four exposures that were 20–90 minutes’ duration within a period of four days. This resulted in severe dermatitis and loss of hair for a prolonged period, affecting his chest and back. They not only experimented on themselves, as Reid recorded: “Passage of the rays for an hour through the head of a laboratory boy of medium intelligence did not in my hands cause deterioration or improvement thereof.” (Scot.Med.Surg.J. 1897)

Speedy progress

Today this research wouldn’t be permitted for legal, ethical and moral reasons. However, had the seriousness of the side effects been appreciated, progress in developing the clinical application of x-rays may have been abandoned or delayed.

It’s difficult to ascertain who was responsible for producing the first radiograph in Britain, but it’s generally accredited to a Scottish electrical consultant, Campbell Swinton, who did this on 13 January 1896.  X-ray departments soon sprung up in hospitals around the UK. Dr John MacIntyre set up the world’s first x-ray department in Glasgow Royal Infirmary in March 1896, less than six months after the initial discovery of x-rays themselves.

X-rays were readily accepted by the general public and some thought they could cure a headache!

Nurses’ role

Nurses were involved from the early days of this patient service: in 1911 Dr George Pirie in Dundee referred to ‘a nurse to help the patients’, in 1913 Dr James Riddell of Glasgow Royal Infirmary wrote of ‘a Sister and 5 Nurses (I think by arrangement we could do with less)....I expect to have a nurse to assist me’. This is surely the first and last example of a radiologist admitting he could do with fewer staff. Also in 1913 Dr Archibald McKendrick of Edinburgh Royal Infirmary wrote of ‘One nurse who attends to galvanic and faradic methods of treatment only’ and from 1914–25 a Sister made x-ray films under the supervision of a physics master at Allan Glens’s School.

So, contrary to my impression that radiologists and radiographers were initially involved with patient care in radiology and nurses became involved some time later, it seems that nurses have been caring for patients undergoing imaging procedures since the early days of the specialty.

Other parts of the UK?

As this presentation was originally developed for nurses in the north east of Scotland, information on this area was of particular interest – however, I’m sure this was replicated in many areas of the UK. If you have any information about the development of radiology or radiology nursing in your areas, I’d be interested to hear about it, or perhaps you can write an article for the next newsletter. Email community.editor@rcn.org.uk

Grace Johnston