Radiation Used to Treat Tumors

Journal article

By: Emil H. Grubbe

Date: 1902

Source: Emil H. Grubbe. "Emil H. Grubbe on the X-Ray." Medical Record, 1902.

About the Author: Emil Grubbe was born in Chicago, Illinois, to parents who were German immigrants, on January 1, 1875. By the age of thirteen, he had become a full-time worker. His first job was washing bottles and running errands at a drugstore. At his next job, working as an office boy at Marshall Field's, he piqued the interest of Marshall Field, who encouraged Grubbe to go back to school and study science and medicine. By the time he was fifteen years old, Grubbe had decided to attend medical school; however, because of his lack of formal education, it was necessary for him to complete his basic education before he could gain acceptance. He studied at the Northern Indiana Normal School (in Valparaiso) during the day and worked as a watchman at night. In 1895, he entered Hahnemann Medical College of Chicago. His facility for the study and teaching of science soon came to the fore, and he was given an academic teaching appointment in physics and chemistry while he was, himself, a student. Grubbe was fascinated by Roentgen's discovery of X rays in November of 1895—so much so that he immediately set about acquiring his own vacuum discharge tube. The remainder of his life was dedicated to the study and utilization of X rays. Grubbe, Edison, and many of their contemporaries began studies designed to specify the varying uses of the Roentgen rays. Rather early on, Grubbe developed extensive dermatitis of the hands and neck, which he immediately surmised to be a result of the application of the rays. His peers strongly encouraged him to begin experimenting with the use of his radiation apparatus in the treatment of cancer. His clinical work was quite successful, and, in February 1896, he opened the very first radiation therapy facility in Chicago. He continued in the active practice of medicine until 1947 and died of complications resulting from multiple malignancies in 1960.

INTRODUCTION

Dr. Emil H. Grubbe (1875–1960) is one of the American pioneers of radiation therapy. While a student at Hahnemann Medical College in Chicago, Illinois, he developed a fascination with Roentgen's discovery of radiation; this passion guided Grubbe's entire professional career. By the end of 1895, Grubbe had acquired a vacuum discharge tube and had begun a series of experiments on the ray's fluoroscopic capabilities and their medical implications. While researching the rays, Grubbe developed dermatitis of the hands and neck and believed that the dermatitis was related to his unprotected use of radiation. As a result, Grubbe and his colleagues made the cognitive leap to practical use of the rays for curative purposes and undertook studies of the rays' effects on patients who had various types of carcinomas. He reported great success and, in February 1896, opened the first radiation therapy facility in Chicago at South Cottage Grove Avenue.

Grubbe continued his medical studies and graduated from Hahnemann in 1899. He accepted a faculty position and rose to the position of chair of electrotherapeutics and radiography, a position that he held until 1919. By the early 1900s, he was teaching at four universities and colleges in Chicago, as well as maintaining a medical therapy practice. Grubbe was a prolific writer, and published nearly one hundred scholarly articles during the course of his professional career. Although he was initially a medical generalist, his main interest was in the use of radiation to treat disease, and he gradually focused his practice more and more in that arena. By the second decade of the twentieth century, he had restricted his medical practice exclusively to radiation therapy. Grubbe continued the private practice of radiation therapy until his retirement in 1947. Throughout nearly his long professional career, Grubbe struggled with radiation dermatitis and anemia—eventually resulting in the amputation of his left hand in 1929.

Grubbe was considered by many colleagues to be challenging, grandiose, and self-important. In the earliest days of his career, he reported that he was too busy to publish the results of his radiation studies—a delay that led to professional contentions that he was not quite as much of a pioneer as he purported to be. However, from a historical standpoint, he is considered to be among the first American radiation therapists.

PRIMARY SOURCE

We have a number of other patients who have taken x-ray treatment, and who have remained free from recurrence for periods ranging from six months to a year and a half. Many other cases could be cited, but time and space forbid.

In conclusion, we wish to submit the following deductions:

1. The x-ray is the most remarkable therapeutic agent of the decade.
2. In properly selected cases of so-called "incurable conditions" the x-ray has brought about remarkable results.
3. Relief from pain is one of the most prominent features of the treatment.
4. Retrogressive changes are noticed in all primary cancer or tuberculous growths.
5. The x-ray has a pronounced effect upon internal cancers.
6. The greatest value of the x-ray is obtained in treating post-operative cases to prevent recurrences.
7. The proportion of clinical cures by this treatment is greater than that obtainable by any other method of treatment.
8. We are positively justified in assuming an idiosyncrasy to x-rays.
9. The peculiarities of each case must be studied in order toget the best results, i.e. no strict rules for treatment can be laid down.
10. Dermatitis, if properly produced, is within certain limits a desirable feature of x-ray treatment.
11. Since the vacuum of an ordinary x-ray tube changes constantly, such tubes are useless for radio-therapeutic work, and only tubes which allow of [sic] perfect control of vacuum should be used.
12. The x-ray has a selective influence on cells of the body; abnormal cells being affected more readily than the normal.
13. Hemorrhages and discharges are decidedly lessened and, ultimately, cease in the majority of cases.
14. Even in the hopeless, inoperable cases, the x-ray prolongs life, makes the patient comfortable, and the last hours free from pain.

The use of the x-ray is, without doubt, a very valuable addition to the therapeutics of malignant disease, and cannot demand too much attention from the progressive physician.

SIGNIFICANCE

The discovery of radiation was followed swiftly by extensive research and practical application of its myriad therapeutic uses—evolving into the study and practice of radiation oncology. These therapeutic uses of radiation have had a profound impact on human life. Shortly after Roentgen discovered the "new light"—which he subsequently named X rays—in 1895, scientists such as Emil H. Grubbe began to do research on and develop practical and therapeutic uses for the rays, which were touted as nothing short of miraculous. Almost simultaneously, it was discovered that Roentgen's X rays could penetrate flesh to illuminate the bone beneath and also could cure malignancies and other disorders.

Roentgen discovered the X ray quite by accident—he was researching light phenomena and other emissions using an evacuated glass tube (the cathode ray tube). He is purported to have looked at his hand as he held different substances between the tube and a screen, and been astonished to have seen the bones of his hand. When he publicly announced the results of his work, others grasped quickly the potential implications of such a discovery.

X rays soon were used to cure both surface and deeply embedded malignancies and other health maladies. Although Grubbe and others also quickly discovered the negative side effects of exposure to the rays—such as dermatitis and burns—the curative and life-lengthening effects of the X rays were believed to far outweigh any negative side effects.

Emil Grubbe reportedly undertook the first systematic use of radiation therapy for the treatment of cancer on January 29, 1896, when he began work with a patient who had advanced and recurrent breast cancer. He treated her with a series of eighteen daily one-hour doses of radiation. This treatment appeared to have a locally curative effect, however, the patient died of metastatic carcinoma soon after the end of her treatment.

Thomas Edison, whose research with X rays resulted in the development of the fluoroscope, expanded upon the work of Grubbe and his contemporaries. He suspended his work with radiation when his assistant and friend, Clarence Dally, experienced radiation burns and died in 1904.

In the late 1890s, a Boston dentist named William Rollins designed shielding devices that dramatically reduced the number and degree of radiation burns. This led to an exponential rise in the use of radiation technology. In 1907, Clyde Snook developed and implemented a high-voltage power supply. The development of this power supply eliminated the need to use chemical or mechanical interruptors and large induction coils and dramatically improved the speed of radiation therapy delivery. In 1913, William Coolidge invented the hot-cathode X ray tube; his invention made X rays widely available for use by the medical community for the first time.

The exponential development and implementation of radiation—and radiation oncology—technology has continued through the twentieth and into the twenty-first century. Roentgen's rays and Grubbe's low-voltage prolonged exposure radiotherapy have evolved into modern radiological treatment and diagnostic procedures such as angiography, ultrasonography, CT (computed tomography), MRI (magnetic resonance imaging), SPECT (single photon emission computed tomgraphy), and PET (positron emission tomography) scanning.

FURTHER RESOURCES

Books

Hodges, Paul C. The Life and Times of Emil H. Grubbe. Chicago: University of Chicago Press, 1964.

Periodicals

Grubbe, E. H. "Priority in the Therapeutic Use of X-rays." Radiology 21 (August 1933b): 156-162.

Grubbe, E. H. "Who Was the First to Make Use of the Therapeutic Qualities of the X-ray?" Radiological Review 22 (August 1933a): 184-187.

Web sites

American Society for Therapeutic Radiology and Oncology. "One Hundred Years of Radiation Oncology." 〈http://www.astro.org/pdf/History/hundred.pdf〉 (accessed September 1, 2005).

IMPAC Medical Systems. "Intensity Modulated Radiation Therapy—The Shape of Things to Come?" 〈http://www.impac.com/company/pressroom/ind_arts/lpr01042.html〉 (accessed September 1, 2005).

X-Ray Accessory Corporation. "The Amazing Powers of the Rays." 〈http://soyeeproductsny.com/The%20Amazing%20Powers%20Of%20The%20Rays.htm〉 (accessed September 1, 2005).

X-Ray Accessory Corporation. "New Avenues of Advertising." 〈http://www.soyeeproductsny.com/New%20Avenues%20For%20Advertising.htm〉 (accessed September 1, 2005).