INFLUENCE OF ROENTGEN RAYS UPON METABOLISM 889 



over the thighs, the neck and chest continued in good condition and showed 

 absolutely no symptoms although kept under observation for a period of 

 several weeks. It seems to these authors, therefore, tending to confirm 

 the opinion of Hall and Whipple, that injury to the intestinal epithelium 

 plays no small part in the systemic reaction following exposure to 

 roentgen rays. Denis and Martin have suggested also that the reaction 

 after exposure of the abdomen may be due, in part at least, to acidosis 

 on the basis of a lowering of the alkaline reserve, since the administration 

 of sodium bicarbonate by mouth for twenty-four hours following ex- 

 posure serves to ameliorate or prevent the constitutional symptoms iu 

 many instances. 



Strauss in a study of the local reaction due to x-rays concludes that 

 there is no real idiosyncrasy but a lessened local resistance in some cases. 



Various general symptoms such as headache, malaise, weakness, undue 

 fatigue, unusual need of sleep, fretfulness, irritability, disorders of men- 

 struation, attacks of dizziness have been said by Gudzent and Halber- 

 staedter to be caused by repeated and long continued exposure to radio- 

 active substances. Ordway(c) in a study of the occupational injuries due 

 to radium points out that such symptoms are common in many people at 

 times and as they cannot be accurately and objectively recorded they 

 may have been due to close confinement, tiring routine, lack of outdoor 

 exercises and other causes. The exposures of some of the cases reported, 

 however, were doubtless large, some were engaged in the manufacture of 

 radium apparatus and others in the therapeutic application of radio- 

 active substances. It is therefore probable that certain general symptoms 

 did occur as a result of this exposure. 



Mottram and Clark estimated by photographic method the daily 

 amount of radiation received by clinical workers making daily applica- 

 tions of radium. These workers received daily scattered over the entire 

 body about 1.4 per cent of the total radiation received by a patient during 

 a course of treatment for superficial carcinoma. 



Because of these constitutional symptoms and the effects of radiation 

 upon the blood forming organs great caution and even frequent alternation 

 of service is necessary for those engaged in the use of radioactive sub- 

 stances. 



We have personally seen a profound constitutional reaction in a 

 patient injected intravenously with active deposit. Because of this 

 and the widespread character of the lesions produced great care should 

 be exercised in the internal administration of radioactive substances. 



Theories of Action. Hertwig and his school believe that radiations 

 cause a specific destructive action upon the chromatin of the cells. Swartz 

 considers that the injury to the cells is due to the destruction of the 

 cell lecithin by the radiations. Packard suggested that radiations acted 

 indirectly on the chromatin and protoplasm by activating autolytic en- 



