Nov 8, 1895 - 2016

X-ray – a fascinating discovery that changed the world

German Röntgen Museum

One night, Wilhelm Röntgen discovered a phenomenon completely by chance that went on to become a specialized medical discipline that would help millions of patients worldwide.

The discovery
On 8 November 1895 at the University of Würzburg, Germany, the physicist Wilhelm Conrad Röntgen discovers a new, unknown type of rays, which he names X-rays.

Like most physicists of his day, Röntgen was studying electric discharges in glass vacuum tubes...

He would use photography to document his findings.

Two days before Christmas in 1895, he took an X-ray of the hand of his wife, Anna Bertha.

And radiology was born.

Shortly before New Year’s Eve in 1895, Röntgen submitted his manuscript for publication to the secretary of the Physics and Medical Society in Würzburg.

In early January 1986, he received the prints.

He sent them, along with nine X-ray images, to some of his physics colleagues in Europe.

The famous physicist Lord Kelvin replied stating that he had looked at the images “with great interest”.

However, he expressed some doubt over their authenticity.

One physicist believed that he had been “told a fairy tale.”

The Austrian newspaper ‘Die Presse’ is the first to report on the new rays on 5 January 1896. Journalists get carried away by ‘fantastical future speculations à la Jules Verne’: the diagnosis of bone fractures, the detection of foreign bodies, and cross-sectional images of the human body. These would all later become reality.

Transparent world
People are fascinated by the new possibilities of looking inside things. Everything is X-rayed.

An impressive amount of detail can be seen in these early X-rays.

X-rays become a funfair attraction.
People stand in line, as they do here at an exhibition in New York, for a chance to see their bodies in X-ray light.

Alongside the X-ray mania during these early days, scientists begin to ask questions. What type of matter can be penetrated by X-rays, and what cannot?

A social debate also takes place. On the one hand, there is hope for medical miracles, and on the other, the fear of loss of privacy.

X-rays take over medicine
The dream of the transparent human comes true for medicine with the discovery of X-rays.

The first X-ray facilities in Germany, England, France and the U.S. open in the spring of 1896.

The patient stands in front of the X-ray tubes for the procedure.

The generator produces the required high tension of several thousand volts to operate the tubes.

The doctor sits in front of the patient. The fluorescent screen allows him to view the X-rays in the darkened room.

In addition to bone fractures, impalpable foreign bodies can now be rendered visible. This is useful for a surgeon performing an operation to remove a foreign body.

Images of soft body parts, such as organs and vessels, cannot be produced with X-rays. The rays pass through them with barely any resistance. It is not until contrast agents are invented that such images become possible.

This also works on living organisms, such as these frogs. The X-rays show how the food, which has been mixed with the contrast agent...

...moves from the stomach... the intestines.

The quality of the X-ray tubes is also improved.
Doctors can regulate the type and amount of X-rays in a consistent and reproducible manner.

X-ray dangers?!
At first the new rays are used indiscriminately, which inevitably results in serious injuries. Radiation burns disappear initially. But many X-ray doctors and assistants suffer long-term damage, such as cancer or the loss of hands and arms. How can they effectively protect themselves?

Is shielding the solution?
X-rays cannot penetrate lead.
Much of the protective clothing at this time resembles suits of armour.

The severity of the skin damage depends on the amount of X-rays it receives. The first instruments for measuring the amount of X-rays absorbed by the body significantly help reduce radiation damage in the clinics.

Various methods for measuring X-rays are tested.
But there is still a long way to go before a standardised system for measuring the amount and type of X-rays is established.

Put to the test
X-rays are used in medicine on a large scale for the first time during World War I. Experiences from field hospitals confirm that modern medicine is not possible without X-rays.

A vast number of X-rays are taken at field hospitals. They help the doctors plan operations on soldiers with bullet and shrapnel wounds.

World War I results in a devastating loss of over 9 million lives.
Additional mobile X-ray machines and medical staff are needed in the field hospitals.
The X-ray equipment is mobilised and transported to the field hospitals in X-ray wagons.

Examinations and operations often take place under the most basic conditions.
Most of the devices are primitive or outright dangerous. The medical staff is often not adequately trained.

The experiences and knowledge acquired from field hospitals are collected and analyzed in many books. The resulting radiology atlases contain impressive contemporary documents.

Helpful rays
The damaging effects of X-rays are used in radiation therapy to destroy malignant tissue and tumours.

The first case in 1897 involves a young girl with an extremely hairy back. The hairiness disappears after the radiation. However, the treatment leaves behind a large ulcer.

The patients must therefore be protected. Facial skin diseases are also treated with X-rays. The patients wear lead masks to protect the rest of the face.

Different masks are worn depending on which part of the face is to be treated.

The lead masks are heavy. This one weighs 8 kg.

Any technology can be used as a weapon.

Knowledge about the treatment of uterine cancer with X-rays is exploited to perform abortions and forced sterilisations during the Nazi era.

For deeper tumours, higher-energy or ‘hard’ beams are required. These can penetrate more deeply into the body.

The tubes and conduit cables in later radiation therapy machines are sheathed for radiation and high voltage protection.

Mandatory X-rays
X-rays play a significant role in treating tuberculosis, one of the most contagious and deadly infectious diseases in the world. It is a widespread disease in Central Europe in the middle of the 20th century.

Tuberculosis can be detected on an X-ray of the lungs before it progresses to a contagious stage.

Routine X-ray examinations, or mass screenings, become mandatory for the population. This regular monitoring is a key factor in reducing the incidence of tuberculosis.

X-ray buses travel to town squares and schoolyards in the countryside. While the mass screening programme is successful, there is still a risk of tumours.
Mass screening is discontinued in the 1980s.

Modern breakthroughs
X-rays have a big disadvantage: they portray the three-dimensional body as flat. All the structures are superimposed. One invention will change this and lay the foundation for modern medical imaging.

The invention of computed tomography is a major advance. With CT, the X-ray tubes rotate around the patient. A detector on the opposite side measures the oncoming X-rays. The images are calculated from the attenuation patterns.

This procedure allows cross-sectional images of the body to be created without superimposition. Soft body parts can be well visualized. Images of the brain can also be obtained for the first time.
A suspected brain tumour is confirmed in the first patient to undergo CT.

Continuous images through the body can now be produced, such as on this CT image of the torso.

Computed tomography and magnetic resonance tomography, along with increasingly sophisticated image processing, allow a more highly detailed view into the human body.

The technology continues to advance. The smallest brain structures and even brain activity can now be imaged.

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