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Early History of the X-Ray Department at Presbyterian Hospital

By Richard E. Buenger, M.D. (1995)

Scarcely had the news of Roentgen's discovery of x-rays come off the wires in 1895 than the staff of the Presbyterian Hospital took steps to provide the hospital with whatever values could be obtained by x-rays in diagnosis and treatment. In the first two or three years the apparatus was very crude and its use more or less dangerous and experimental. By 1897, however, it had been found possible to demonstrate one kidney stone, and from this time forth, the apparatus, the technic and the interpretive values grew each year. For diagnostic work the factor of speed was limited by the necessary use of mechanical or chemical interrupters and large induction coils. A primary weakness also lay in the low rating and poor controllability of available gas tubes. These weaknesses were mainly overcome when Clyde Snook of Philadelphia brought out the interuptless transformer (about 1907) and William Coolidge of Schenectady provided the famous "Coolidge Tube," still in use the world over.

Aside from the great interest shown by the medical and surgical staff of the hospital, the credit for equipping and conducting early operation of the department belongs to Dr. Joseph F. Smith, who took up this work as a Rush student and continued a few years after graduation. Dr. Smith became an early and active member of the American Roentgen Ray Society (formed in 1900) and benefited by his contacts with all the eastern groups who were largely responsible the early advances in America. He brought the x-ray department to the forefront in comparison with other Chicago hospitals and kept it there. But Dr. Smith always had an eye on a surgical career and on April 1, 1906, he left for a year of surgical training in Vienna. On his return he settled in Wausau, Wisconsin, where he met with great success, and took his turn as President of the Wisconsin Surgical Society.

On the day of his leaving, a Rush student, Hollis E. Potter, was brought in to serve the department. His background, history and experience were as a teacher of physics and chemistry. He had much experience in scientific photography, from micro to stellar. He was admitted as a member of the American Roentgen Ray Society after his graduation from Rush in 1908.

In the succeeding period, radiology had a natural healthy growth but the space in the hospital allotted to this work became inadequate. So from time to time, increased space had to be acquired somehow. The front office preferred to consider floor space as primarily a place to put beds for sick people. In their fight for space the x-ray personnel once had to steal a large room across the hall (which was poorly used) and to hastily install apparatus for gastrointestinal work and for the removal of foreign bodies in the bronchi at their own expense, in order to retain possession. This was the period when many of the newer advances in radiology appeared in the publications from Germany, and to keep abreast of the times the American radiologist had to read German "fluently" or lag behind.

Potter carried on at the Presbyterian for nine years but in 1915 left for private work in the city. His background experience in physics enabled him to develop a number of new methods in this newest division of medical endeavor. He did research on scattered radiation which later (1917) led to his development of the moving grid diaphragm. He was the first president of the Chicago Roentgen Society and in 1923 became president of the American Roentgen Ray Society. He later received medals for research from all the national societies and became an honorary member of the special societies in New York, Detroit., Minnesota, Argentina and Columbia.

In the early days of x-rays the clinical "atmosphere" at the Presbyterian Hospital was especially stimulating. On the medical side were such men as Billings, Herrick, Sippy, Irons and Post. The surgeons were Bevan, Murphy, Lewis, Graham and Senn. Men of this caliber demanded the highest grade of accuracy in diagnosis and were ruthless in their criticism of diagnostic failures. This made for the best training possible in the x-ray department.

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