March 30, 191 ij 



NATURE 



157 



THE USE OF RADIO-ACTIVE SUBSTANCES 



IN THERAPEUTICS. 

 'T^HE British Medical Journal for February 4 contains a 

 ■*■ report of an address delivered befoi'e the Berlin 

 Medical Society on January 18 by Prof. Wilhelm His, of 

 the University of Berlin, on " fhe Treatment of Gout 

 and Rheumatism by Radium." Prof. His was led to 

 make the investigations upon which the address was 

 founded by the consideration that radium, or at all events 

 some of its derivatives, formed a constituent of certain 

 natural curative springs, the action of which on gout and 

 rheumatism is undoubted, though medical men have not 

 been able to explain it satisfactorily. It soon became 

 evident that both radium and radium emanation were cap- 

 able of producing cures, which were especially remark- 

 able m the case of gout and of the various rheumatic 

 affections. The results obtained were reported by the 

 lecturer about a year ago to the German Balneological 

 Society. Since then his experience has considerably 

 extended. 



The patients dealt with include 100 cases of chronic 

 rheumatism and 28 of uric acid gout. Of the former, 47 

 were improved, 29 considerably improved, 5 nearly cured, 

 while 19 were uninfluenced by the treatment. The most 

 interesting of the cases were those in which limbs renderer" 

 useless by the disease were almost completely restored by 

 the treatment, which was continued for periods of three 

 months or longer. In gout, the results were much more 

 striking. Twenty-eight patients were kept under treat- 

 ment and under observation for a considerable period. Of 

 these, 4 remained unaffected, while in 24 a marked 

 improvement in the condition was achieved. Some of the 

 patients have remained free from symptoms for a year i 

 after the termination of the treatment. 



The most remarkable effect is noted in the behaviour 

 of the uric acid in the blood. Under the influence of 

 radium emanation, the blood loses its uric acid within a 

 few weeks. This was observed in 15 cases out of 18. On 

 the other hand, the uric acid persisted in the blood of 3 

 patients even after a severe course of treatment. On two 

 occasions actual deposits of uric acid under the skin of 

 the ear (so-called " tophi ") were seen to disappear during 

 the treatment. The clinical improvement did not always 

 run parallel with the uric acid content of the blood. Thus 

 very marked improvement was obtained in a patient by 

 energetic treatment, though the blood continued to con- 

 tain uric acid. In another patient no uric acid was pre- 

 sent in the blood either at the beginning or the end of 

 the treatment, although he had gouty nodules all over his 

 body. 



When water containing radium is drunk, part of the 

 emanation is taken up in the inspired air, and another 

 part is absorbed from the stomach and intestine. Emana- 

 tion behaves like every other gas which is not a normal 

 constituent of the body. It is excreted to a very slight 

 extent through the kidneys, and to a large extent in the 

 expired air. When the treatment is carried out by baths, 

 absorption is only continued so long as the patient remains 

 in the atmosphere laden with emanation from the bath 

 water, and the foreign gas is excreted immediately. On 

 the other hand, when carried out by means of drinking 

 waters, the absorption takes place slowly from the intes- 

 tine, and the body is being constantly supplied with fresh 

 doses of emanation for -three or four hours after a single 

 dose. When the patient is given from three to five doses 

 during the day, emanation can be detected in the expired 

 air at any period of the day. 



Radium itself behaves in the body like other heavy 

 metals ; that is to say, it is absorbed slowly, and the 

 absorbed quantity is excreted again through the intestine. 

 So long as it is present in the body, small quantities of 

 emanation are continuously developed from it. It is there- 

 fore clear that the most active application of emanation 

 is achieved when the individual is breathing an atmosphere 

 which contains a certain quantity of radium emanation. 

 Under these conditions, an equilibrium will rapidly be 

 established between the emanation content of the outer 

 air and that of the blood. This equilibrium will be main- 

 tained so long as the body remains in this atmosphere. 

 The emanation content of the blood will reach a level in 

 this way which can only be attained by the drinking of 



NO. 2 161, VOL. 86] 



exceptionally large quantities of water containing radium. 

 Experiments have shown that it is usually sufficient for 

 the purpose of obtaining definite curative results, and of 

 ridding the blood of gouty patients of uric acid, to place 

 the patient in an air containing from two to four " making 

 units " per litre for two hours a day. " Emanators " 

 have been constructed on this principle. A stream of 

 oxygen bubbles through a fluid containing a salt of radium 

 and is saturated with emanation. The emanation issuing 

 from the fluid is distributed equally in the air of the room 

 bv a ventilator. This method, however, has the dis- 

 advantage that it can only be applied when a special 

 emanator is available. A portable inhalation apparatus 

 has also been constructed. 



With regard to the mode of action of radium, the most 

 important factor appears to be the property possessed by 

 radium of rendering various ferments of the body more 

 active than usual. Phis power of activising ferments has 

 been demonstrated in the case of pancreatin, pepsin, lactic 

 acid ferment, diastatic ferments, and autolytic ferments. 

 It is probable that the same is true of numerous other 

 ferment actions in the body, though not for all ; for 

 example, it is known that the excretion of sugar bv 

 diabetics is not influenced by radium. In the case of 

 gout, this property of radium can be demonstrated in a 

 very clear manner. The disturbance in gout has been 

 shown to depend on a slowing of the purin body meta- 

 bolism, and not only is the formation and breaking down 

 of uric acid slowed, but the mutual relations of the two 

 processes are altered. In the gouty this is shown bv the 

 fact that, on a diet free from purin, though containing 

 nucleic acid, the uric acid formed is not completely 

 excreted within five days, as is the case in healthy per- 

 sons. After prolonged treatment with emanation, how- 

 ever, the excretion takes place as promptly and completely 

 as in a healthy individual. Gudzent was further able to 

 show that uric acid and its salts are dissociated into 

 carbon dioxide and ammonia under the influence of this 

 action, and he demonstrated in a very ingenious manner 

 that neither radium nor radium emanation produces this 

 dissociation. It is due to radium D. Thus the actions 

 that come into play in the treatment of gout by radium 

 are very varied. In addition to the autolytic action, the 

 action inhibiting inflammation, and that alleviating pain, 

 there is a specific action on the uric acid and its salts, and 

 on the processes regulating the quantity of uric acid in the 

 body. 



Another radio-active substance — mesothorium — has been 

 prepared in considerable quantities by Dr. Otto Hahn. 

 As compared with radium, the want of durability of this 

 preparation is amply compensated by the greater ease with 

 which it can be obtained from raw material. It is niore 

 than probable that other radio-active substances will be 

 discovered, and will bring the treatment of gout and allied 

 complaints by radio-active substances within the reach of 

 all. A great deal of experiment and observation is still 

 required, more particularly to make sure that no evil 

 results may appear side by side with the undoubted benefit 

 which has already been obtained. A. C. Jordan. 



THE AERO AND MOrOR EXHIBITION. 



THIS exhibition opened at Olympia on Friday, March 

 24, and will continue until Saturday, April i. A 

 general survey of the flying machines shown indicates that 

 the crank inventor is less conspicuous than has been the 

 case at former exhibitions, and that the British makers 

 have achieved notable progress during the past twelve 

 months both as regards design and workmanship. Most 

 of the machines have evidently been designed and con- 

 structed with a view to military requirements. Thus 

 among foreign machines is the Breguet three-section 

 military biplane, one of the favourites with the French 

 War Department. This machine is built almost entirely 

 of steel, thus cutting down the number of parts and the 

 amount of wiring. The spars of the wings consist of large 

 diameter steel tubes, to which the ribs are elpstically 

 attached, forming a supple surface which is claimed to 

 give almost entire automatic stability. Another French 

 War Department machine is the Nicuport two-sealer 

 monoplane, chiefly remarkable for its high speed — 63 mile.* 

 per hour. 



