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THE KING'S CONVALESCENCE.
881
certainly not to be despised. But when the growth in such cases are visualised, does it not seem rather much to expect that any implanting of radium tubes can cope satisfactorily results
are
numerous
THE
LANCET.
tracks of
with advanced disease ? For these reasons the method of applying gamma rays externally deserves the most careful consideration LONDON: SATURDAY, APRIL 27, 1929. by those who are to put into effect the recommendations of the Radium Committee’s report. In the view of a correspondent (see p. 898) whose experience carries THE KING’S CONVALESCENCE. weight, the logical development of our present-day of thanks to his people has knowledge is the use of large quantities of radium at a His MAJESTY’S message been followed by the welcome news that his convales- distance from the body. Let us suppose that a deepseated tumour is exposed to the gamma rays from as cence is now assured, and that no further daily as 4 or 5 grammes of radium element, held at a much statements as to his progress will be issued. The of 10-12 cm. from the surface of the body. distance has followed with anxious interest medical profession If the radium is placed in a suitable container the in of his the illness which story every stage long began five months ago,’the first formal bulletin being issued lateral spread of the rays can be prevented to some and an almost cylindrical beam may be on Nov. 21st, and will join with a special pride in the extent, national sense of thankfulness that the measures pictured entering the surface of the body and diverging in its passage through the tissues. A adopted for the KING’s treatment have ended so only slightly conical zone of radiation extends from the slightly happily. incident to the emergent surface, the intensity gradually gettting weaker owing to increased distance and absorption. The question to be considered is this : THE EFFECTIVE USE OF RADIUM. can deep-seated tumours be adequately treated in this THE Radium Subcommittee, whose report we so that the malignant cells get the necessary summarised last week, stated that the amount of way, dose without the skin suffering any serious damagebradium available to-day, although greater than it was If the answer is in the affirmative, then the principle in 1926, is quite inadequate even to cope with the of selective action requires no further demonstration, most pressing needs of medical treatment. While and a method exists by which patients can avoid technical methods have been elaborated for the Evidence is accumulating from the operation. treatment of cancer by radium in almost every region clinics of Paris, Brussels, and New York that these of the body, the radium required for the purpose is not expectations are not groundless, but there has not yet there, and no common policy exists among the hospitals been time for more than preliminary reports on this for its acquisition or use. The Committee recognises work. In this country there is no centre where the that for many years to come research and treatment method is being tried. Individual gifts of radium are must continue to be intimately associated if progress to supply the large amount of is to be made, for our present knowledge is not rarely big enough radium needed for this type of treatment. We trust adequate even to decide whether the gamma radiation, that the national scheme outlined by the Radium which is the essential part of radium therapy, is best Committee may lead to the formation of one or two, applied at close quarters- to malignant growths within centres where the value of the method can be the body or whether the future lies rather with determined. massive doses of penetrating rays applied at a distance. It may be recalled that the first medical men to use radium therapy were the dermatologists, PROFESSIONAL HOSPITALS. who applied radium to the surface of more or less WE publish on page 908 a letter above the signature. superficial growths. The next advance was made by the clinical pathologists, DOMINICI and REGAUD, who " Forward," which contains the brave notion that treated growths by actually inserting the radium. the counter-actions implicit between a State hospital, Since their work began great advances have been and a voluntary hospital system would disappear made in surgical radium therapy, and in this country under a scheme whereby the medical professioninterest has developed on the side of surgical technique itself would control and manage the institutions as (in many cases it must be said most ingeniously) to part of the professional machinery-as "their own the comparative neglect of the possibilities of treating industry," in the words of the writer. The scheme follows on these two assumptions-first, that the cancer by external radiation with a large quantity of radium. Obviously, there can never be such a thing arguments against a State service, which have been. from time to time adduced in these columns,haveas uniformity of irradiation of a tumour by the method of insertion of tubes, needles, seeds, or any been found convincing ; and, secondly, that the weak other such sources of radiation. Take, for instance, places in voluntary hospital administration, as any one of the usual methods for treating inoperable briefly brought forward, are of such a nature that carcinoma of the neck of the uterus ; the insertion of the medical profession might be well advised gradually tubes into the cervical canal, along with applicators to withdraw their support of them. The alternative its the setting up of a system of hospitals, which for or needles to supplement their action, inevitably leaves some regions of possibly invaded tissues convenience may be termed " professional hospitals," inadequately irradiated. A malignant growth of the bo be managed by the medical practitioners of each tongue in which the glands are already involved i,rea. At a time when the whole hospital adminisdiscloses a distribution of malignant cells which tration of the country may be described as under would tax a geometer to irradiate uniformly by public review in the light of recent legislation, embedding tubes. The problem is still more difficult Forward’s " communication invites comment. in the case of a tumour of the breast with all its The first reflection that his proposal evokes possible ramifications. This has not discouraged so s that to a great extent hospitals, whether in courageous a worker as G. L. KEYNES, and his ’eceipt of State subsidy or conducted on the
certainly not to be despised. But when the growth in such cases are visualised, does it not seem rather much to expect that any implanting of radium tubes can cope satisfactorily results
are
numerous
THE
LANCET.
tracks of
with advanced disease ? For these reasons the method of applying gamma rays externally deserves the most careful consideration LONDON: SATURDAY, APRIL 27, 1929. by those who are to put into effect the recommendations of the Radium Committee’s report. In the view of a correspondent (see p. 898) whose experience carries THE KING’S CONVALESCENCE. weight, the logical development of our present-day of thanks to his people has knowledge is the use of large quantities of radium at a His MAJESTY’S message been followed by the welcome news that his convales- distance from the body. Let us suppose that a deepseated tumour is exposed to the gamma rays from as cence is now assured, and that no further daily as 4 or 5 grammes of radium element, held at a much statements as to his progress will be issued. The of 10-12 cm. from the surface of the body. distance has followed with anxious interest medical profession If the radium is placed in a suitable container the in of his the illness which story every stage long began five months ago,’the first formal bulletin being issued lateral spread of the rays can be prevented to some and an almost cylindrical beam may be on Nov. 21st, and will join with a special pride in the extent, national sense of thankfulness that the measures pictured entering the surface of the body and diverging in its passage through the tissues. A adopted for the KING’s treatment have ended so only slightly conical zone of radiation extends from the slightly happily. incident to the emergent surface, the intensity gradually gettting weaker owing to increased distance and absorption. The question to be considered is this : THE EFFECTIVE USE OF RADIUM. can deep-seated tumours be adequately treated in this THE Radium Subcommittee, whose report we so that the malignant cells get the necessary summarised last week, stated that the amount of way, dose without the skin suffering any serious damagebradium available to-day, although greater than it was If the answer is in the affirmative, then the principle in 1926, is quite inadequate even to cope with the of selective action requires no further demonstration, most pressing needs of medical treatment. While and a method exists by which patients can avoid technical methods have been elaborated for the Evidence is accumulating from the operation. treatment of cancer by radium in almost every region clinics of Paris, Brussels, and New York that these of the body, the radium required for the purpose is not expectations are not groundless, but there has not yet there, and no common policy exists among the hospitals been time for more than preliminary reports on this for its acquisition or use. The Committee recognises work. In this country there is no centre where the that for many years to come research and treatment method is being tried. Individual gifts of radium are must continue to be intimately associated if progress to supply the large amount of is to be made, for our present knowledge is not rarely big enough radium needed for this type of treatment. We trust adequate even to decide whether the gamma radiation, that the national scheme outlined by the Radium which is the essential part of radium therapy, is best Committee may lead to the formation of one or two, applied at close quarters- to malignant growths within centres where the value of the method can be the body or whether the future lies rather with determined. massive doses of penetrating rays applied at a distance. It may be recalled that the first medical men to use radium therapy were the dermatologists, PROFESSIONAL HOSPITALS. who applied radium to the surface of more or less WE publish on page 908 a letter above the signature. superficial growths. The next advance was made by the clinical pathologists, DOMINICI and REGAUD, who " Forward," which contains the brave notion that treated growths by actually inserting the radium. the counter-actions implicit between a State hospital, Since their work began great advances have been and a voluntary hospital system would disappear made in surgical radium therapy, and in this country under a scheme whereby the medical professioninterest has developed on the side of surgical technique itself would control and manage the institutions as (in many cases it must be said most ingeniously) to part of the professional machinery-as "their own the comparative neglect of the possibilities of treating industry," in the words of the writer. The scheme follows on these two assumptions-first, that the cancer by external radiation with a large quantity of radium. Obviously, there can never be such a thing arguments against a State service, which have been. from time to time adduced in these columns,haveas uniformity of irradiation of a tumour by the method of insertion of tubes, needles, seeds, or any been found convincing ; and, secondly, that the weak other such sources of radiation. Take, for instance, places in voluntary hospital administration, as any one of the usual methods for treating inoperable briefly brought forward, are of such a nature that carcinoma of the neck of the uterus ; the insertion of the medical profession might be well advised gradually tubes into the cervical canal, along with applicators to withdraw their support of them. The alternative its the setting up of a system of hospitals, which for or needles to supplement their action, inevitably leaves some regions of possibly invaded tissues convenience may be termed " professional hospitals," inadequately irradiated. A malignant growth of the bo be managed by the medical practitioners of each tongue in which the glands are already involved i,rea. At a time when the whole hospital adminisdiscloses a distribution of malignant cells which tration of the country may be described as under would tax a geometer to irradiate uniformly by public review in the light of recent legislation, embedding tubes. The problem is still more difficult Forward’s " communication invites comment. in the case of a tumour of the breast with all its The first reflection that his proposal evokes possible ramifications. This has not discouraged so s that to a great extent hospitals, whether in courageous a worker as G. L. KEYNES, and his ’eceipt of State subsidy or conducted on the