June 30, 1911] 



SCIENCE 



1003 



literating endarteritis) ; the round-cell infil- 

 tration becomes intense; the connective tissue 

 fibers are (Edematous and stain poorly. In 

 the epidermis the cells show extreme degenera- 

 tive changes; they become vacuolated, the 

 nuclei are fragmented, there is degeneration 

 of the cytoplasm so that stains are taken 

 poorly, and complete breaking down of many 

 cells. These changes are especially intense in 

 the highly specialized and active cells of the 

 appendages of the skin — the hair follicles and 

 the sweat and sebaceous glands — and they 

 may result in the obliteration of these struc- 

 tures, a phenomenon which, occurring as it 

 may without destruction of the surrounding 

 tissues, is not produced by any other known 

 agent. In the last stage in a radium reaction 

 there is necrosis of all of the affected tissues, 

 the connective tissue stroma being the most 

 resistant and last to break down. In diseased 

 tissue of the skin such as epithelioma (can- 

 cer) and lupus (tuberculosis), there is the 

 same sort of reaction; it is also found that 

 the pathological tissues which are composed 

 of growing cells, often of embryonic type, 

 react in the same way as the active sensitive 

 tissues of the normal skin. They are more 

 sensitive to the effects than the stroma in 

 which they are growing, disintegrate or de- 

 generate readily, and are destroyed before or 

 without destruction of the connective tissue 

 around them. 



It is evident in this process that we are 

 dealing with an agent whose results are pro- 

 duced by influencing the biological processes 

 of the cells themselves. The effects are not 

 produced by an immediate destructive action 

 of the rays, as a heat burn, for example, is pro- 

 duced. There is no immediate effect from the 

 application of radium; it is only after days, 

 it may be two or three weeks, that the effects 

 appear. The inference is that the radiations 

 set up some process in the tissues which itseK 

 ends in their destruction. The whole process 

 is one of exaggerated stimulation of the ac- 

 tivity of the cells of the tissues : a stimulation 

 which varies in degrees with the degree of 

 specialization or functional activity of the 

 different type of cells. In its slightest degrees 



it is the ordinary protective process that oc- 

 curs under exposure to sunlight, but under the 

 unusual and extreme irritation of this arti- 

 ficial form of radiant energy the reaction be- 

 comes destructive. 



Since the effects of radium have had 

 therapeutic application, it may be interesting 

 to pause to consider briefly this aspect of the 

 subject. 



As I have suggested, the effects of radium 

 to a degree are selective in that they excite 

 the intensest reaction in the cells of great 

 functional activity whether this be in the 

 exercise of a special function or the simpler 

 function of growth. Thus there is produced 

 by radium: (1) A stimulation of the cells; 

 (2) an exaggerated effect upon the highly 

 specialized structures of the epidermis, viz., 

 the hair follicles, and the sebaceous and 

 sweat glands, and likewise upon the basal or 

 germinal layer; (3) an endarteritis or pro- 

 liferation of the lining membrane of the 

 blood vessels which may lead to obliteration 

 of many blood vessels; (4) destruction of 

 masses of diseased tissues, which are com- 

 posed of young growing cells or immature 

 cells. 



These effects upon tissues suggest the pos- 

 sible use of radium for various therapeutic 

 purposes, as follows : (1) To stimulate chronic 

 processes. This principle has been success- 

 fully used in the treatment of some chronic 

 inflammatory processes in the skin. (2) To 

 destroy or diminish the follicles of the skin, 

 particularly the hair follicles. This prin- 

 ciple has had practical application with X- 

 rays, but because of the small quantities avail- 

 able, not with radium, except in the case of 

 hairy naevi (birthmarks). (3) To obliterate 

 blood vessels in the skin. This has had 

 practical application, with very successful re- 

 sults, in the treatment of vascular nsevi 

 (birtlunarks). (4) To destroy pathological 

 tissues. This use is of course possible of wide 

 application, and has been successful in vari- 

 ous diseases of the skin and the adjacent 

 underlying structure, especially in carcinomas 

 and sarcomas (cancers). Its limitation in 

 cancer is that it is only effective upon such 



