LETTERS

Rule of law, not men To the Editor: As a graduate of Yale College but not the medical school, I was pleased to begin receiving Yale Medicine. However, drawing upon my Yale education as a major in American history, I have always believed in the American tradition stating that we are a nation of laws, not men. Thus, I read with interest the article and the quotation attributed to the medical school's new dean in your Fall 1997 issue. As a non-smoking physician, I share Dr. Kessler's view of smoking and the tobacco companies. However, the deals being forced on the tobacco companies are unconstitutional and an attack on the rule of law. In a recent issue of The Freeman, Robert A. Levy makes the case that we can't ignore the constitutional infirmities just because the industry consents to them; that tobacco is not a special case and that other industries should be fearful; that prohibition as favored by Drs. Kessler and Koop would lead to a black market; that in fact cigarette smokers already pay more through the taxes on their cigarettes than the cost for their care; and that Congress should first eliminate all subsidies to tobacco before resorting to a legislated settlement. I hope that Dean Kessler will encourage those in training to understand that a superb education with free choice and not a paternalistic attitude is the essence of a Yale education. Robert H. Potts Jr., M.D. Copper Mountain, Colo.   To tell the truth To the Editor: I came across your very nice article on the history of radiology at Yale [Medicine's new eyes, Winter/Spring 1998]. I applaud your department, its innovations and your enthusiasm for its capabilities. At the same time, I question the statements you make on attributing “the first X-ray image in the United States” to Yale physicist Arthur W. Wright. Sometimes issues like this are a matter of semantics. Although we attribute the “discovery” of X-rays and the first image to Roentgen, Crookes (and others) actually made X-rays and inadvertently exposed X-ray plates in his laboratory well before Roentgen developed an understanding of what was going on. As you may be aware, Crookes thought the gelatin plates were defective and repeatedly returned them to Ilford, England's largest manufacturer of photographic plates, with a vitriolic note. It took a scientist of Roentgen's caliber to realize what was occurring and to publish an account of his experiments. Hence, we attribute this great discovery to Roentgen. It is much the same with the first (clinical) X-ray in the United States. After reading a detailed description of Roentgen's discovery of the X-ray in the New York Sun, a prominent local man and a member of the Dartmouth scientific society, Howard H. Langell, inspired Frank Austin, an assistant in the Dartmouth physics laboratory, to test a dozen or so Crookes vacuum tubes in the Dartmouth collection to see if any of them would produce X-rays. It was probably on or before the very date you describe, Jan. 27, that Langell and Austin produced images of coins and keys in a wooden box and perhaps even of Austin's hand. They then reported this event to Edwin Frost, a professor of astronomy at Dartmouth. On Monday, Feb. 3, Edwin's brother, Gilman Frost, M.D., chief of staff at the Mary Hitchcock Memorial Hospital, brought 14-year-old Eddie McCarthy to the physics building at Dartmouth college. Eddie had fallen a week or so before while skating on the Connecticut River and had a clinical diagnosis of a “colles” fracture. Utilizing the tube that Austin had experimented with, the Frost brothers proceeded to produce an X-ray of McCarthy's wrist showing the fracture. Frost reported this in an article dated Feb. 4 and submitted it to the journal Science. Reports in the same issue of Science by Drs. Pupin of Columbia and Goodspeed of Pennsylvania described clinical X-rays that were made three and five days later. If Yale's physicist, Arthur Wright, pre-empted the Dartmouth group, it remains unreported and unsubstantiated, at least in the scientific literature. The Dartmouth group went one step further. The taking of the first clinical X-ray in America was captured by photographer Henry H. Barrett and so remains the first scientific experiment recorded by photographic means. In a word, from Vox Clamantis in deserto, “strong on the 'Lux', weak on the 'Veritas'.” Peter K. Spiegel, M.D. Professor and Chair Department of Diagnostic Radiology Dartmouth-Hitchcock Medical Center Lebanon, N.H. You're both right To the Editor: Because of my mixed medical heritage (B.M.S. Dartmouth Medical School, M.D. Harvard Medical School, and ophthalmology residency at Yale), I receive the alumni bulletins of all three institutions. I read with great interest your excellent article Medicine's new eyes. I was greatly impressed by the claim that Yale physicist Arthur W. Wright made the first X-ray image in the United States on Jan. 27, 1896, just one day after an article entitled The New Photography appeared in the New York Sun newspaper describing Roentgen's discovery of X-rays on November 8, 1895. In the Winter 1995 issue of Dartmouth Medicine an article appeared describing the first clinical X-ray in America: of the wrist of Eddie McCarthy, a 14-year-old boy who fell while ice skating on the Connecticut River in Hanover, N.H. This first clinical X-ray was taken at Reed Hall at Dartmouth College on Feb. 3, 1896, and reported in an article published in Science dated Feb. 4, 1896. Physics professor Edwin Frost (and brother of Dr. Gilman Frost, a professor at Dartmouth Medical School and physician of Eddie McCarthy) wrote: “It was possible yesterday to test the method on a broken arm. After an exposure of 20 minutes, the plate on development showed the fracture in the ulna very distinctively. Comment upon the numerous applications of the new method in the sciences and arts would be superfluous.” Yale's first X-ray image combined with Dartmouth's first clinical X-ray shows that these two institutions were (and continue to be) on the cutting edge of medical technology. It should also be remembered that Dartmouth and Yale share a common heritage, that of Nathan Smith, founder of Dartmouth Medical School in 1797 and co-founder of Yale Medical School over a decade later. John D. Bullock, M.D. Professor and Chair Department of Ophthalmology Wright State University School of Medicine Dayton, Ohio Class agent syndrome To the Editor: A syndrome described in the December 1997 Atlantic Monthly attracted my gaze. Now I know what causes my swollen legs: economy class syndrome, interestingly first described by Professor Jennett of Glasgow University! As an American of Scottish descent, I now understand the connection between my ethnic heritage, the legendary gift for thrift and my puffy ankles after a bargain flight. Another, which I call class agent syndrome, much more pleasant, is often seen in Yale medical alumni class agents after many years on the job. This condition may be experienced all year, depending on correspondence with classmates, but predominates each fall and peaks sharply every five years. Manifestations: frequent memories and thoughts (even dreams) of classmates, living and dead. Enjoyable. Seriously desire to know if other class agents have noted same. Richard W. Breck, M.D. '45 Wallingford, Conn.   < top of page >   Originally published in Yale Medicine, Summer 1998. Copyright © 1998 Yale University School of Medicine. All rights reserved.