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USE OF RADIUM IN MEDICINE BECLEKE 209 



iiiiiy be introduced into the interior of the natural body cavities. 

 The needles can even be made to penetrate the diseased tissues. 

 They are minute but marvelously active and powerful sources of an 

 invisible radiation. 



In these tubes or in these needles can be sealed instead of radium 

 I he gaseous substance or " emanation" which by a process of atomic 

 disintegration is a residium from the radiation from radium. The 

 focus of radioactivity formed by this isolated and imprisoned ema- 

 nation is not, like radium, an unchanging capital of constant revenue, 

 but decreases and decreases at such a rate that in less than four days 

 it loses one-half its original value. Nevertheless its use has certain 

 advantages. 



X rays and gamma rays in strong doses may totally destroy the 

 living tissues just as do caustics; but in smaller doses they seem to 

 make a choice, to exercise what may be called a selective action since, 

 from among the diverse living cells of the exposed region, they kill 

 some and leave others intact. In reality they make no selection, but 

 tlie various cells of our skin, muscles, and nerves are very unequally 

 sensitive to their destructive action. The reaction of the various 

 cells to the same dose of the rays is as different as that of various 

 substances — paper, cloth, woodwork, metals — immersed at the same 

 temperature in a flame. 



Those living cells which are the most sensitive to the rays are as 

 a rule those which multiply the most rapidly. Such are general^ 

 the cancer cells and consequently they are greatly sensitive to these 

 radiations. We may look upon the X rays and the gamma rays in 

 effect as knives or rather invisible darts marvelously tempered and 

 subtle, capable of riddling with Avounds the whole diseased region, 

 of piercing it without the flowing of blood, without mutilation, 

 through intact skin, and of killing in an internal organ the cancerous 

 cells, at the same time leaving alive the neighboring healthy tissues. 



The varying chances of success of the treatment, the often insur- 

 mountable difficulties in its application, and the undeniable dangers 

 depend essentially upon the degree of difference in the sensitiveness 

 of the cancerous and the normal cells to the radiations. This differ- 

 <>nce, sometimes very great, is oftentimes small, and may entirely dis- 

 appear. This, leaving aside other obstacles, is the great stumbling 

 block to the successful treatment with these penetrating radiations. 



Radium is therefore not a panacea, applicable to all cancers and 

 capable of curing a cancer at any stage of its growth. Only under 

 certain conditions it is an excellent weapon. Its applications, hovr- 

 ever, increase as the very delicate technique of its use is improved. 



For quite a while the knife has given place to X rays, and for a 

 somewhat shorter time to radium, in the treatment of superficial 

 cancers, especially of the face and lips. It is only during the recent 



