My friend Bob Gayler loaned me a small book that tells, in 100 tightly written pages, all an aspiring radiologist needs to know about how x-rays are generated, how patients should be positioned, and what to look for in images of various body parts. I thought of sending the book to the American Board of Radiology as a guide for announced revisions in its diagnostic exams.
One detail may inhibit the American Board of Radiology’s acceptance. The book was written in 1913, and there have been a few changes since then. It is the product of Arthur C. Christie, a national leader of radiology for several decades and a founder of the ABR. In 1913, he was the chief radiologist in the US Army.
“The small number of medical officers in the service necessitates one to familiarize himself in a comparatively short time with the essentials of radiologic technic. It has been the author’s aim to limit this work to the absolute essentials, a knowledge of which will enable the operator to do satisfactory work in x-ray diagnosis.
“The book may also be found useful by that increasingly large number of physicians in private practice who find it necessary or expedient to do their own x-ray work. Resort to a specialist in radiology is earnestly recommended whenever such services can be obtained,” Dr. Christie emphasized in his preface.
The volume preceded introduction of the Coolidge hot cathode tube. The first part discussed the properties of electricity, essential to setting up an x-ray unit, the power sources—induction coils, static machines, transformers—the quirks of vacuum tubes and how to deal with them, maintaining the vacuum and controlling the energy levels, and how to keep from blowing the tubes by warming cold tubes slowly and cooling hot tubes gently. To test the tubes for fluoroscopy, he suggested “using some object such as a skeleton hand as an indicator. It is very dangerous for the operator to use his own hand because of the liability to x-ray dermatitis and its sequels.”
The physics part of the board examination would be covered by a chapter explaining how the generators, transformers, and tubes functioned. “Electrical resistance depends upon the material of which the conductor is made, the diameter of its cross-section, its length and its temperature. Copper wire is one of the best practical conductors, iron wire not so good and German silver one of the poorest.”
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