Neuroradiology in Boston: historical beginnings.

Within weeks of Röntgen’s report of the discovery of x-rays in December 1895, the news of the discovery rapidly spread by cable and word of mouth to North America. Dr Warren, then professor of surgery at the Harvard Medical School, came back from Röntgen’s laboratory with a “shadow picture of the human hand in which the outlines of the bones were apparent” (1). The Massachusetts General Hospital (MGH) at the time was fortunate to count among its personnel an inspired and enthusiastic young man named Walter Dodd, who was both the hospital apothecary and the hospital photographer (2). Dodd, a British cockney by birth, had entered upon a scientific career after the manner of Faraday, as a janitor in a Harvard chemistry laboratory (3). Because the new discovery was thought merely to be a refinement of photography, Dodd was considered to be the most appropriate individual to be put in charge of the new technology (4). The department at the MGH thus began as an annex of the apothecary. In March 1896, together with his assistant, Joseph Godsoe, Dodd obtained a commercial x-ray tube and, with locally acquired electrical equipment and a static generator energized by a human operator turning a crank, began to experiment (5). The first clinical use of x-rays in Boston probably was by either Dr Francis H. Williams or Dr E. A. Codman, each of whom published his results in the Boston Medical and Surgical Journal in February and March, 1896 (8, 9). At the same time, John Trowbridge, director of Harvard’s Jefferson Physical Laboratory, was making similar experiments. His article in the New York Journal, which appeared on February 2, 1896 (10), included a photograph of the bones of the human hand. One of the first pictures taken at the MGH, presumably by Dodd and Godsoe, was that of a needle in the palm of the hand (6). Grigg believes that Dodd did not obtain good results until after June or perhaps July 1896 (7). Walter Dodd, after acquiring a medical degree, was named skiagrapher to the MGH in 1908/1909. Unfortunately he also turned out to be one of the first victims of excessive radiation exposure, ultimately dying of metastatic lung cancer after carcinoma of the hands in 1916. Harvey Cushing and Emory Codman, house officers at the MGH in the spring of 1896, also “began to see what we could do in the way of getting similar pictures” (1). There is no publication indicating that their efforts were successful, although Cushing’s biographer, Fulton, states that Cushing, together with Codman, helped install an x-ray tube at the MGH. “We have at last succeeded in having an x-ray machine put in for which I have subscribed largely and hope the conservative staff will ultimately remunerate us for it” (11). Cushing left the MGH in the fall of 1896 (with an x-ray tube that he took with him from the MGH, somewhat to the consternation of the staff there) to go to the Johns Hopkins Hospital in Baltimore, where he was successful in obtaining x-rays of the neck (after exposures averaging 35 minutes) of a Baltimore woman, Lizzie W, “shot in the neck by her bartender husband during a family brawl.” The bullet was identified in the body of the 6th cervical vertebra, and the case was reported— probably the first US publication of the application of x-rays to identify a lesion of the head or spine (12). Between 1896 and 1910, the chief use for x-rays was to demonstrate fractures or foreign bodies. Attempts had been made in the United States within a few years of Röntgen’s discovery to demonstrate brain tumors by x-ray, as deAddress reprint requests to Samuel M. Wolpert, MD, Division of Neu-