Friday, November 16, 2018

When Radium Came to Grinnell...

Many history textbooks describe the last years of the nineteenth and first years of the twentieth century in Europe and America as the "Age of Progress." A wave of inventions and a general rise in the standard of living in parts of the northern hemisphere encouraged an optimism that only dimmed when World War I and the "Spanish flu" worked their deadly spells. However, among the developments that gave rise to optimism was the 1898 discovery of radium. Applications did not immediately appear, but gradually the medical community came to realize that the powerful rays emitted by radium might be used effectively to treat disease. Enthusiasm over the newly-discovered element led to the founding in 1913 of a new journal, Radium, "devoted to the chemistry, physics and therapeutics of radium and other radio-active substances."
Cover of first issue of new journal, Radium (April 1913)
At about the same time, news reports began to appear about radium's medical uses. For example, an article in the May 4, 1915 issue of the Ottumwa Courier told of a Keota man who had been hospitalized in Chicago for cancer of the neck. After four months there had been no improvement. But then the patient became the lucky experiment of a German doctor, newly arrived in Chicago and eager to demonstrate the utility of radium therapy. Three applications later, the patient reported that "he feels like a new man," and he returned home to resume his earlier way of life.

As reports of the curative powers of radium multiplied, more and more physicians grew eager to make use of this new therapy. In September, 1917 the University of Iowa announced that it had purchased "two tiny tubes of radium, the weight of which was but 50 milligrams, combined." Although the acquisition had been pricey—$5000—Dr. Bundy Allen declared that "the state now has a valuable equipment for the cure of cancer and other malignant diseases" (Marshalltown Times-Republican, September 29, 1917). Saying so did not prevent the university from losing its precious medicine. As the Daily Iowan reported, the radium was lost in the course of treating a cancer patient who had a tube containing radium placed in her mouth.
When the time came for its removal it was found that the contents of the tube had entirely disappeared. The patient was ignorant of the way in which the radium was lost (Daily Iowan, November 28, 1920). 
Iowa was not alone in losing track of these minuscule, but costly, radium batches. The Des Moines News (November 12, 1920) reported that a Utica, New York hospital had also lost its radium while treating a patient. "The radium burned [a patient] and in irritation she took off the bandage containing the tiny radium tube and threw it down a drain pipe," obliging the hospital to tear up its sewer system in search of the precious commodity. Closer to home, a physician in 1928 Waterloo sought help from Coe College's electroscope to retrieve a tiny ("one-fortieth as large as a dime") bit of radium that was "thrown by accident into a furnace, along with some surgical refuse" (Coe College Cosmos, October 28, 1928).
Undated photograph of A. James Larkin (1888-1936 )
(History of Medicine and Surgery and Physicians and Surgeons of Chicago [Chicago: Biographical Publishing Corporation, 1922], p. 645)
Meantime physicians across the country embraced radium treatment for a surprisingly broad array of illnesses. In 1929 A. James Larkin, a Chicago doctor who specialized in radium therapy, published Radium in General Practice, a physician's guide. The table of contents, each line of which detailed some illness or part of the body for which radium therapy was recommended, occupied two entire pages. In addition to examining radium's use on numerous forms of cancer, Larkin detailed how radium could benefit sufferers of vernal conjunctivitis, deafness, ringworm, nevus, and much else. Presumably there were illnesses for which radium was not suitable, but physicians seemed to be finding more and more applications.

Given the potency of the chemical, radium treatment demanded only small quantities applied for brief periods. In practice this meant placement of a small tube or needle of radium directly on or within the affected area. The idea was that the radium would "burn away" tumors, which seemed more susceptible to the radioactive emissions than healthy tissue. The difficult part was to make certain that the radium damaged only cancerous cells; when this goal was achieved, radium treatment became an effective competitor to surgery.
Illustration of containers used in radium therapy
(A. James Larkin, Radium in General Practice [NY: Paul B. Hoeber, 1929], p. 6)
But the minute applicators necessary raised other problems, obliging physicians to apply secure tethers to make certain that the valuable containers of radium were not ingested or otherwise lost (a lesson learned too late by some of radium's early enthusiasts). Indeed, Larkin was at pains to warn physicians to make certain that the radium applicator was "firmly attached to some object or part of the patient's body during the application so that it is impossible to lose control of it at any time...." This problem was especially urgent when treating the mouth, nose, throat, uterus, rectum, bladder or esophagus (Larkin, Radium, p. 16), all body parts to which radium was frequently applied.
Title page of L. L. Myers's study
(University of Iowa Studies in Medicine v. 1, n. 5 [July 1919])
Although radium therapy gradually exhausted its welcome among physicians, it is easy to understand the enthusiasm with which it was originally received. In a 1919 paper devoted to using radium to treat uterine cancer, Dr. L. L. Myers pointed out that radical hysterectomy, until then the primary therapy for uterine cancer, was not only a complicated and taxing surgery; it was also often deadly. According to Myers, among "experienced operators" twenty-five percent of all hysterectomy patients died during or after the operation, but among less experienced or less-skilled surgeons patient mortality often reached fifty percent. Moreover, Myers continued, those who survived radical hysterectomies often experienced severe pain in the pelvis because of the retraction of pelvic tissues. By contrast, placing controlled quantities of radium directly upon the malignant tissue for brief periods occasioned little discomfort and none of the mortality dangers so common to surgical solutions.

A similar argument was made for many other surgical therapies, which helped encourage physicians to prefer radium treatment over the scalpel. For example, in an era when tonsillectomies were very common an increasing number of physicians applied radium cylinders directly to the tonsils. Doing so removed some of the dangers of infection and helped patients resume normal activities sooner. The same dynamic influenced the treatment of skin disorders and other medical specialties.
Grinnell received its first radium in the spring of 1920. Weighing only 12.46 milligrams (about one-quarter the size of the sample that the University of Iowa had acquired), Grinnell's radium arrived "cradled in a needle, fastened in a strong box with boxes and boxes and wrappings and wrappings on the outside." This "tiny but mighty" package cost the Grinnell Community Hospital $1507.20, a staggering outlay for a small-town hospital.
Grinnell Herald, March 12, 1920
Two local physicians, Drs. P. E. Somers and L. A. Hopkins, were named "radium experts" and directed to undertake the training necessary to use radium therapy safely. Hopkins may never have practiced with radium in Grinnell, as he left town for the west coast in 1923, never to return. But Somers clearly did, as several of his professional presentations indicate. At a 1921 meeting of the Iowa Clinical Medical Society in Grinnell, Somers gave a paper on "The Results of Radium Therapy in Epithelioma and Lupus Vulgaris" (Journal of Iowa State Medical Society, vol. 11 [May 1921]:184), indicating that his first treatments in Grinnell likely dealt with skin maladies. The next year at the annual meeting of the Iowa State Medical Society Somers presented a paper on "Chemistry and Medicine," almost certainly detailing more of his work with radium (Journal of the Iowa State Medical Society, vol. 12 [April 1922]:126).

How often and how long Somers pursued radium therapy in Grinnell presently-available records do not make clear. The October 1923 issue of the Grinnell Community Hospital Bulletin devoted a special article to cancer, firmly embracing radium therapy:
The best practice in the treatment of cancer is early removal. It is always preceded by the exposure of the part to Radium where this is feasible, and the area from which the growth is removed is again treated with Radium afterwards. Radium is the best single agent in the treatment of cancers and should be used in all inoperable cases and is the treatment of choice in cancers on the skin.
Each year the hospital published data on the number of patients treated and the therapies applied. The February 1923 bulletin, reporting on 1922 admissions, identified 58 "radium cases" that year, compared with 91 surgeries, figures that confirm the hospital's confidence in radium therapy.

The Drake Community Library Local History Archives does not hold a complete run of the Community Hospital Bulletin, so it is difficult to know exactly how long radium continued to be employed as a cancer treatment at the hospital. The February 1931 issue, however, indicates that at some point before 1930 radium had disappeared entirely from the hospital's cupboard of therapies, perhaps because that year the hospital purchased a new x-ray machine intended for therapeutic as well as for diagnostic use. Consequently, the February 1933 report on hospital admissions in 1932 reported 135 surgical patients and 56 treated by x-ray; no use of radium was reported. The following year showed a similar distribution, again with no reference whatever to radium. Figures for 1937 showed nearly as many patients treated with x-ray (120) as with surgery (124), and in 1938 and 1939 patients treated with x-ray therapy outnumbered surgery patients. Evidently the physicians at Community Hospital had decided sometime in the 1920s that radium therapy was no longer a preferred—or even complementary—therapy for cancer. Perhaps the scare occasioned by the 1925 discovery of disease among women who painted radium onto watches helped persuade Grinnell physicians to seek alternative therapies.
Admission Register of St. Francis Hospital, 1919-1935 (Grinnell Historical Museum)
The register of admissions to St. Francis hospital, however, offers a bit more evidence about radium therapy in Grinnell. To judge by the register, Grinnell's second hospital did not employ radium therapy at all until the 1930s. Throughout the 1920s and early 1930s, St. Francis physicians regularly resorted to surgery to deal with cancer and other problems to which radium had been applied since 1920 at Community Hospital. But after Dr. C. W. Howell (1887-1941) joined the St. Francis staff in 1931, taking over the practice of Dr. Eugene Talbott (1873-1943), St. Francis hospital began to treat patients with radium. Where or when the hospital obtained its radium supply I do not know, but the register indicates that when Mrs. Cedric Barnes entered the hospital on August 3, 1933, she received "radium treatment," the first time that this phrase appears in the register. John Devereux entered hospital the day that Mrs. Barnes left (August 5), and he, too, received "radium treatment," although for what exact problem the register does not say.

After that, Dr. Howell applied radium treatment sporadically, sometimes more than once to the same patient. For example, Mrs. Mary E. Turner entered St. Francis November 14, 1933, was treated with radium, and then dismissed November 18. Two months later (January 13, 1934) she was back in hospital, once again receiving a dose of radium before being sent home the next day. That summer Turner was once again a patient at St. Francis, being admitted August 21 and dismissed Aug 22 after her third radium treatment. J. A. Breeden of Newburg went through two radium treatments at St. Francis, the first occurring in late January 1934 with a follow-up in mid-March. Mrs. J. G. Strovers (Kellogg) and Mrs. Charles Newcomer (Newburg) also both received two radium treatments in 1934. Four other persons underwent at least one treatment at St. Francis in 1933 or 1934, but between the time Mrs. Newcomer was dismissed in late November 1934 and the end of this volume of the St. Francis register (July 31, 1935), no other hospital patients had resort to radium. Without access to the next volume of hospital admissions we cannot know if Dr. Howell continued to use radium therapy, but if he did, his use of radium did not last long, as Howell himself died of a heart attack in 1941.

With so little information, it is difficult to know what to make of Howell's practice, but it appears that his patients may have benefitted from their encounter with radium. Mary Turner, for example, who had had three radium treatments in 1933-1934 lived until 1984 when she died at age 74 "following a lengthy illness." If Howell had treated her for cancer (as the three treatments imply), the radium treatments may well have prolonged her life, even if it was cancer to which she ultimately succumbed.  James Breeden did not live so long as Turner, but it was an automobile accident, not illness, that took his life in 1957 when he was 66 years old. Ross Coutts, who apparently had just one encounter with radium therapy, died in 1965 in the Grinnell hospital, but he was then 81. Therefore, it may be that Dr. Howell's St. Francis patients benefited from radium therapy.

Nevertheless, as practice at Grinnell's Community Hospital indicated, the therapeutic use of radium had clearly peaked by 1930, replaced by newer, safer therapies. In its heyday, however, the very word—even without its potent radioactive energy—exerted enormous power across American culture, and was especially prominent in the marketplace, tempting entrepreneurs to associate almost any product with radium.
Many of these products never came near actual radium, but bore the name in the hope that buyers would eagerly scoop up anything associated with the latest wonder. Dry goods stores, for example, advertised that seamstresses could purchase "radium silk," and clothing stores offered pajamas or petticoats made of "radium silk." As a 1922 advertisement for Grinnell's Brintnalls Dry Goods store put it, "What girl's heart wouldn't be joyous just to feel the soft, clinging Silk in these garments" (Scarlet and Black, December 6, 1922)? "Radium slips," which advertisements admitted were made from rayon satin, were on offer from Younkers in Des Moines, so almost certainly some women in Grinnell wore them. Men's stores in Marshalltown sold cotton socks bumped up by being called "Radium 100" or "Radium 400," so these too could likely be found in Grinnell dressers in the 1920s.
Radium butter probably did not make it onto grocery shelves in town, but it illustrates the lengths to which advertisers would go to hype their products. One of the most amusing products in this group was something called "Radium Spray," which borrowed the idea of radium's power to allege that the spray "cleans everything except a guilty conscience."
Advertisement from Des Moines Daily News, May 25, 1912
Most of these products were harmless, containing no radium whatsoever. But some entrepreneurs not only borrowed radium for the names of their products, but also actually used radium in their products. One of the most widely-known was something called Radithor, "certified radioactive water." Produced in New Jersey between 1918 and 1928, Radithor contained both radium and mesothorium in distilled water. Promoters claimed that, when consumed regularly, Radithor could remedy many ills, including sexual impotence.
Enthusiastic consumers, like Eben Byers (1880-1932), who was said to have drunk three bottles a day for several years, ended up absorbing enormous quantities of radium. Originally buoyed by his use of Radithor, Byers ultimately fell seriously ill, losing his jaw to cancer and developing holes in his skull. When he died in 1932—a victim of radiation poisoning—he was buried in a lead-lined coffin; when exhumed in 1965, his body was found to be still highly radioactive. Unfortunately, Byers was not alone; experts estimate that some 400,000 bottles of Radithor had been purchased, leaving many other consumers afflicted with radiation poisoning. So far as I could determine, no Iowa publication advertised Radithor, so perhaps Grinnellians remained safe from its radioactive nostrum.
Headline from the Ames Daily Tribune, April 1, 1932
But Radithor was not the only culprit in this wave of quackery. Radium Appliance Company of Los Angeles advertised a "Radio-Active Pad" to be worn on one's "back by day and over the stomach at night." The pad was said to cure "Neuritis, Rheumatism, High Blood Pressure, Constipation, Nervous Prostration, Asthma..., Heart, Liver, Kidney and Bladder trouble."
Advertisement from Mason City Globe-Gazette, October 21, 1930
Other uses seemed less threatening. For example, as early as 1918 Grinnellians learned that they could buy from Hoffmeister's jewelry store on Broad Street wrist watches with genuine radium dials that would glow in the dark. Only later did purchasers learn that the women who painted the radium on watch dials had themselves become victims of radiation poisoning. By the late 1920s, the sordid tale of the "Radium Girls" took much of the wind out of radium's sails.
Advertisement from the Scarlet and Black, October 6, 1918
Nevertheless, hucksters attached the promise of radium to rouge, chocolate bars, suppositories, and much else.
Advertisement from the Chicago Tribune, March 9, 1919
The lure of radium also attracted beauty salons that promised "radium treatments" alongside "vapor baths" and other cosmetic therapies.
Advertisement from Des Moines Register, December 13, 1925
Physicians eager to collect patients attuned to the latest craze advertised in newspapers their commitment to "radium treatment." Davenport's Dr. C. E. Glynn, for instance, advertised "Radium treatments" along with "X-ray diagnosis of the heart, lung, stomach and kidney" (Davenport Daily Times, December 6, 1921). In Estherville R. C. Coleman, M. D. advertised "Operations and Radium Treatments" (Estherville Daily News, July 24, 1930). Inevitably, therefore, swindlers showed up, taking advantage of people's fascination with something they poorly understood. In 1927 both Illinois and Michigan pursued Fred Ashner who was wanted in a dozen Michigan and Illinois communities for "faking 'radium' treatments of persons in rural communities" (Davenport Daily Times, December 20, 1927). Some places, like Davenport, established their own institutes, the better to coordinate delivery of radium therapy. Larger cities like Chicago saw the establishment of services that provided either on-site radium therapy or rented out radium to physicians who contemplated radium therapy for patients.
Journal of Iowa State Medical Society, vol. 11(1921)
But then radium's moment in the sun passed.  Even the journal Radium, which had been born on the eve of the element's explosion into medical practice, closed down, its last issue published in 1925, the same year that the public heard about "Radium Girls." Soon the country's newspapers reported the sad tale of Eben Byers's deadly embrace of Radithor, further dulling the gloss on radium's future. As the Great Depression bore down on the country and a new war gradually came into view, radium—dangerous and expensive—lost its hold on the medical profession. The early deaths of enthusiasts like A. James Larkin did nothing to stall radium's death spiral. No longer did hospitals need to spend large sums for tiny tubes easily swallowed, thrown into the toilet, or otherwise lost. Radium's replacement, X-ray therapy, was also expensive, but provided a more controlled dose to aim at tumorous tissue without the same risk of loss, and rapidly edged radium out of medical practice. Certainly in Grinnell the Community Hospital abandoned radium therapy already in the 1920s; why it made a brief comeback at St. Francis Hospital in the 1930s is unclear, but after the death of Dr. C. W. Howell, radium therapy in Grinnell seems to have come finally to an end.

Public fascination with this wonder remedy also passed. Suddenly radium butter and radium silk seemed much less appealing than they had seemed a decade earlier.