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Historical Notes: the Gifts of Physics to Modern Medicine

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Historical Notes: the Gifts of Physics to Modern Medicine Indian Journal of Z-Zi&ry of Science, 40.2 (2005) 229-250 The Gifts of Physics to Modern Medicine The advancement of medical science was, and is, and will always be dependent on the progress of fundamental sciences like mathematics, physics and chemistry. It is true that pure science is not rapidly converted to applied science. That has always to depend on further technological advancement and on craftsmen's innovation. The role of physics in the evolution of some mod- ern medical equipments - both diagnostic and therapeutic, is simply unique. A chemical pathology laboratory comprises, overall physics (i.e. laboratory ma- chinery, pressures, radioactivity, voltage, etc). 'The Book ofNature is written in Mathematical Characters' - said Galileo Galilei (1564-1642) and nothing is static in nature; nature is dynamic. That Earth moves around the Sun (helio-centric - Greek - 'helios' - 'sun') was the discovery of Nicolaus Copernicus (1473-1 543). Nature is in motion. William Harvey(1578-1657) was influenced by both Galileo and Copernicus; blood is not static inside the body; it circulates. A physician's mentor were the astro- physicists. Here lies the importance of fundamental sciences in the making of modern medicine. The year "1543" is the Anna Mirabilis in the relationship between Natural Sciences and Medical Sciences when De Revolutionibus Orbrium Coelestium (On th Revolution of Heavenly Bodies) of Nicholaus Copernicus, and De Humani Corporis Fabrica Libri Septem (The Seven Books on the Structure of the Human Body) of Andreas Vesalius (15 14-1564) were published. It was an auspicious year. The discoveries of eminent physicists like Wilhem Conrad Roentgen (1845 - 1923), First Nobel Laureate in Physics in 190 1, Albert Einstein (1879 - 1955), Nobel Laureate in Physics in 1921, and Georg Von Bekesy (1 899 - 1972)' Nobel Laureate in Physiology on Medicine in 1961 made significant contribu- tions to the development of many essential medical equipments. Medical men like Niels Ryberg Finsen (1 860 - 1904), Nobel Laureate in Physiology on Medi- cine in 1903, and Willem Einthoven (1 860 - 1927), Nobel Laureate in Physio- INDIAN JOURNAL OF HISTORY OF SCIENCE logy on Medicine in 1924 also applied principles of physics in the making of medical instruments used in both therapeutic and diagnostic fields. X-Rays X-rays are invisible electro-magnetic radiation having a much shorter wavelength than light between lo8 and 3 x 10-'I metres. It was discovered by Wilhelm Rontgen in 1895. Originally this was called Rontgen rays. An anato- mist, Rudolf von Kolliker (1 8 17 - 1905), who was at a lecture demonstration by Rontgen, proposed that the rays be called 'X' and they subsequently re- ceived the discoverer's name. They are produced by transitions of electrons in the inner levels of excited atoms or by rapid deceleration of charged particles. A common means of production is by firing electrons into a copper target. X- rays are useful in medicine since different components of the body absorb X- rays, to a different extent, but enough radiation passes through the body to register on a photographic plate beyond. X-rays pass through wood, metal and other materials, unlike light and heat waves. Being an avid photographer, he set up a film before the screen, laid his wife's hand on the plate, and got the world's first X-ray picture, showing both bones and the wedding-ring! Weeks later (De- cember 28,1895) he sent a report to the scientific academy (Medical -Physical Society) in Wurzburg - 'On a New Kind of Radiation' (Ubereine neue Antvon Strahlen). It was his first communication. The second, on January 13, 1896, was in Berlin in the presence of Kaiser Wilhelm 11. The last time he spoke in public on the subject of X-ray was again in Wurzberg on January 23,1896. At the end of the presentation, his friend Professor von Kolliker lent his hand for the production of a radiography in front of the audience. On March 9 and 10, 1897 Rontgen published two other papers on this subject. That was all. The news of Rontgen's discovery spread, at first by the press. On Janu- ary 2, 1896, Rontgen sent a reprint of his report of December 28, 1895 to his fellow physicists, including Franz Serfin Exner (1849 - 1926) in Vienna, Frederich Wilhelm Kohlrausch (1 840 - 19 10) in Gottingen, Henri PoincarC (1 854 - 19 10) in Paris and Arthur Schuster (1 85 1 - 1934) in Manchester. The information spread from friend to friend, and Exner passed it to Ernst Lecher (1 856 - 1926), son of the editor of the Freie Presse ofvienna. This is the reason why the first public mention of the discovery of X-rays was published in Vienna on Sunday, January 5, 1 896 in the Freie Presse. From these, a small number of HISTORICAL NOTES 23 1 European daily papers became aware of the discovery, the first London publi- cation appearing in Monday's Daily Chronicle. On January 6, 1896 a cable from the Evening Standard Correspondent informed the rest of the world. The first notice of Rontgen's discovery in a scientific periodical was published on January 8,1896 entitled 'Electrical Photography Through Solids' in the Elec- trical Engineer of New York. The text was the one used for the international news. On January 11,1896 the same information was published in the medical press - both in the Medical Record of New York and the Lancet of London. Rontgen took no patent on his work, and it is a tragedy that he died in poverty in the period of high inflation in Germany after the World War l(19 14 - 1918). The tentative applications of X-rays marked the beginning of diagnos- tic radiology. They were promoted by a break-through some months after Rontgen's discovery: the discovery of 'radio-active' materials (uranium salts) that generate rays spontaneously by Antoine Henri Becquerel (1 852 - 1908), Pierre Curie (1 859 - 1906) and Marya Sklodowska Curie (1 867- 1934), who jointly won the Nobel Prize for Physics in 1903. Radiotherapy (later used to treat cancer) began with Becquerel's observation that radium carried in his pocket produced a burn. The S.I.Unit of radioactivity is the Becquerel unit (Bq) de- fined as an activity of one disintegration per second. Marie Curie was awarded the Nobel Prize for Chemistry in 1911 for her discovery of polonium and ra- dium - till today she happens to be the first and only double Nobel Laureate in two subjects - Physics and Chemistry (also first lady Nobel Laureate). Satiric Poem in 'Punch' Magazine, London quotes in 1896: "0Rontgen, then the news is true, and not a tick of idle rumour that bids us each beware of you, and of your grim and graveyard humour. We do not want, like Dr Swift, to take our flesh off and to pose in our bones, or show each little rift and joint for you to poke your nose in". Many more kinds of rays were gradually recognised, including electro- magnetic waves (such as radio, X-ray and gamfna ray photons) as well as par- ticles like electrons and neutrons. In time, rays of varying energy could be pro- duced by sources ranging from low-voltage X-ray tubes to high voltage linear 232 INDIAN JOURNAL OF HISTORY OF SCIENCE accelerator on radioactive elements like cobalt. The world of atoms and nuclei was brought into service of medicine.Recently, Electron Beam Tomography (Greek - 'tomo' - slicing) EBT, is used to assess the vascular health of the heart. Ultra Sound Modern ultra-so lurid has its origin in the work or 1 marine8 SO- NAR (Sound Navigation and Ranging), during the First World \ ison- ics is the branch of physics dealing with the theory and applica ~ltra- sound: soundwaves occurring at frequencies too high to be heard by the human ear (that is above 20KHz). During 1930's experiments were initiated into the possibility of using these high frequency sound waves for medical diagnostic DUTDOSC. 411 sound wave:s consisl: merely of mecl hanical 1vibratior lcted through a medium. Audible sound waves fall in the range of 20 - 20,000 cycles per second (now termed hertz or Hz); frequencies above this level area called ultrasound. The frequencies employed in medical diagnostic and therapeutic devices normally lie in the range of 1 - 10 million Hz (1 -10 MHz). At this frequency, the sound can be focused in as much the same way as light. Despite its high frequency, the sound is still conducted merely as mechanical vibrations Y within tlle tissues and is therefore devoid of the potentially damaging ionisation :d with X-rays. As the sound travels through the tissues it is partly reflected at any point where there is a change in tissue density, the strength of the echo being proportional to the density change at the interface. As the sound travels at a constant speed in soft tissues, echoes occurring from deeper struc- tures take longer to return to the surface and thus the deptli and dir section of the tissue giving rise to an echo can be determined by approprriate elec:tronic appa- a ratus like computer. Accurate representation of the structure 01 body organs (medical scanning) can be made. It is produced and detected by high frequency transducers. Echo aortography is the application of ultrasound techniques to the di- agnosis and study of the aorta, particularly the abdominal aorta. Echo cardiog- raphy is the ultrasound cardiography using ultrasound in the investigation of the heart and great vessels and diagnosis of cardio vascular lesions, especially mitral disease, pericardial effusion, and abdominal aortic aneurysm. Doppler HISTORICAL NOTES 233 ultrasonography techniques are used to augment two dimensional echo cardio- gram by allowing velocities to be registered within the echo cardiographic im- age.
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