Ask the Scholar

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    "title": "Other, no date",
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        "Safety Light Collection",
        "Records Related to Radium Dial Painters"
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    "ocrText": "1. Are you familiar with the literature pretaining to the internal administration\nof radium?\n2. Have you ever noted anything in such literature which showed contraindication for\nthe use of radium internally?\n3. Over what period of time does the internal administration of radium extend?\n4. Do you recall when articles first began to appear in the literature with reference\nto this subject?\n5. Have there appeared any articles on this subject of recent date, and if BO how\nrecent?\n6. To the best of your knowledge is radium being used internally by the medical\nprofession at the present time?\n7. Was radium used internally in 1925?\n8. Was radium used internally in 19157\n9. Was radium used internally between the periods of 1915 to 1925?\n10. State your knowledge as to use of radium internally up to the present time, as\ngathered by your experience and your reading?\n11. Have you ever used radium internally?\n12. Have you prescribed the use of radium internally by mouth?\n13. Have you used it by injection, either intravenously, intramuscularly, or sub-\ncutaneously?\n14. During what periods have you prescribed the use of radium internally?\n15. What was the average dosage, expressed in micrograms of radium element, used by you?\n16. What part of a milligram is a microgram?\n17. What part of a gram is a milligram?\n18. What part of a gram is a microgram?\n19. For deep ray therapy can you give us a rough estimate of smallest amount of radium,\nPage -2-\nexpressed in milligrams, that is commonly used?\n20.\nThe largest amount?\n21.\nThis would then represent\ntime the amount ordinarily administered\ninternally, based on the minimum and maximum quantities used for deep ray work?\n22.\nWhat was the maximum amount of radium you administered internally to any single\nindividual?\n25.\nWill you specify generally the conditions for which you prescribed this type of\nmedication, disregarding whether or not the results obtained were beneficial?\n24.\nDid you ever note any untoward effects resulting from the use of radium internally 2\n25.\nIf so, did you ascribe these effects to the reaction of the individual to the\ninjection or to the effects of the radium in the system?\n26.\nAs time elapsed have you had an opportunity to check patients which were given\nredium internally?\nor\n27.\nIf so, have you ever noted the development of any conditions/leisons which may\nhave been aggravated by the presence of radium in the system?\n28.\nYou then state that you used radium internally from\nto\ninternally,\nand that you never noted any untoward effects which could be ascribed to the\nphysiological action of the radium upon the sytem?\n29.\nWhat in your opinion happens to the radium solutions administered internally once\nthey are in the system?\n30.\nIn case that you state they are eliminated, do you have any idea how rapidly such\nelimination occur?\n31.\nAre you familiar with the work of Siol, Viol and Gordon, done in 1915, with\nreference to the rate of elimination of radium administered internally?\n32.\nIs it not true that within 5 days after an injection of radium internally or\nintramuscularly 35 to 45% is eliminated by way of the feces and urine, and that\nradium in solution given by mouth, 65 to 75% is eliminated at the expiration of\n5 days?\n33.\nIs it not true that Siol, Viol and Gordon, further state that after the expiration\nof the 10th day the rate of elimination, regardless of whether the radium was\nPage -5-\ngiven intravenously, intramuscularly or per os, is practically the same and that\nit is less than 1%.\n34. Based upon this work how long & period of time would you assume would be required\nby a patient, who had an injection of say 50 micrograms of radium element,\nbefore it would be practically all aliminated?\n35. Would it not be practically all eliminated in six to eight months?\n36. Are you familiar with the work of Dominicie and his associates, published in the\nliterature around 1910 to '13, with reference to the internal administration of\nradium?\n37. Is it not a fact that Dominicie was directing his efforts towards developing a\nradium preparation which when once introduced into the system would remain for a\nlonger period of time then the common ordinary soluble salts?\n38.\nIs it not also true that Dominicie did not meet with much success in fixation of\nradium even when the colloidal radium sulphate was administered internally?\n39.\nDid he not find that this material was eliminated with about the same expediency\nas the more soluble salts?\n40.\nI assume Doctor that you are versed in the solubility of the various products of\nradium, such as the chloride, bromide and sulphate, and that you are aware that\nthe chloride and bromide salts are readily soluble in aqua solutions, and that\nthe sulphate of radium is considered one of the most insoluble inorganic compounds\non which we have information.\nI further assume that you are aware that radium,\nand the more common element berium are analogous in their chemical behaviour, and\nthat even though barium sulphate is considered practically insoluble, that redium\nsulphate is 100 times less soluble or has a solubility approximately 1/100 of\nbarious sulphate. Based upon these facts let us outline two cases: First -\nthat a definite amount of a soluble salt, such as radium chloride be taken by\nmouth, and second, that a like amount in the form of the sulphate be taken by\nmouth, what would be your assumption as to the course of the radium in these two\ninstances.\n41.\nWould you not assume in view of the highly insoluble nature of radium sulphate\nthat it would practically all be eliminated thru the feces, and that a certain\namount of the soluble salt would in all probability be picked up by the blood\nstream? This question is purely a hypothical one, and one which we ask for your\nopinion based upon the knowledge of the art as of 1915 and 1925, or any period\nbetween these dates, and not in view of the information which we have at the\npresent time?\nPage - 4 -\n42. You are doubtless familiar with certain conditions which have been described in\nthe literature recently, that have been ascribed to the accumulation and retention\nof radium element in the system by people employed in the application of self\nluminous material to watch, clock dials, etc.\n43. I assume Doctor that you are familiar with the method by which the particular\ngirls or operators afflicted, claim to have ingested the material?\n44. You are probably further aware that the conditions which are ascribed to have\nresulted from this type of work, were first described around 1925, and that they\nwere described in the light of being a new discovery?\n45. In view of the facts as developed, let us say in 1925, did you then consider the\ninternal use of radium befraught with any immediate or possible latent hazards?\n46. Did you consider that there was any analogy between the ingestion of radium, such\nas is claimed to have been done in the case of these girls and the administration\nof radium internally under medical supervision?\n47. Are you familiar with the articles by Dr. Harrison Martland, occuring in Vol. 85,\nP.P. 1769, 1925, and volume 92, P.P. 466 to 75 03 552 to 559,1929, issues of the\nJournal of the A.M.A. These articles outline Dr. Martland's analysis of the\nsituation in Jersey. In these articles Dr. Martland states briefly that at\ngirl might ingest anywhere from 15 to 215 micrograms of radioactive substances\nper week. A simple calculation will show that by taking the average 115 micro-\ngrams per week that an operator would waste approximately $11.50 worth of material\nper week. This hardly seema plausible, when one considers that these girls\nwere only getting from $18 to $25 per week. Let us make another assumption\nthat each operator wasted 50 micrograms of radium element per week, and that with\n250 girls working this would mean that during the course of year 680 milligrams\nof radium element would be lost, or approximately 1/3 of the total amount of\nmaterial which was used for this purpose - this on the face of it would seem\nimpossible unless the corporation was extraordinaryly wasteful.\n48. Referring to the work of Flinn, the Journal of the A.M.A. Dec. 18,1926: Flinn\nestimates that an operator who practiced the habit of pointing the brush with her\nlips might ingest approximately 0.5 grams a week, which would contain amount approximately\n7.2 micrograms of radioactive substances. While his estimated/is approximately\n1/2 of the estimated minimum of Dr. Martland, still it seems much more within\nreason. Disregarding the fact of whether or not the practice of pointing the\nbrushes with the lips was ever a common practice or a recognized one, but assuming\nthat one had knowledge at the time these girls were employed, 1915 to 1925, that\nthey were pointing the brushes with their lips, and that they were ingesting\nweekly 7.5 micrograms of radium element, precipitated as the sulphate - would you\nhave considered that there was a possibility that these girls would have absorbed\nPage -5-\nradium which would have remained in their system for & period of years - say\n5 to 10? Give your reasons in detial.\n49.\nHad you known that the girls were absorbing weekly 7.5 micrograms of radium\nelement would you have considered that there might have any possible injury\nresulted from such ingestion either current or latent?\nFor your information allow me to state that in the preparation of self luminous\nsinc sulphide the common practice consists of taking the properly prepared zinc\nsulphide, wetting this with water, and then adding the required amount of radium\nin the form of a soluble salt in solution. To this mixture there is added a.\nsmall amount of an alkaline sulphate salt such as amonium sulphate, with the\nobject of precipitating the radium as a sulphate, such precipitation taking\nplace upon the surfaces of the crystaline zinc sulphide. By such a procedure\nthere is & wide distribution of the radium, as sulphate, over the surface of\nthe sine sulphide.\n50.\nWould not the fact that the radium ingested was in an insoluble form, such as the\nsulphate, led you to believe that there would have been little or no danger\nthru absorption, and that the material would have been readily excreted thru the\nfeces?\n51.\nAre you familiar with New and Non Official Remedies?\n52.\nWill you kindly describe the purpose of this book?\n53.\nIs it not a fact that radium chloride for internal use was recognised by New and\nNon Official Remedies as early as 1915, and continuing thereafter until 1928?\n54.\nDid they not recognize both the intravenous, intramuscular and subcutaneous use\nof radium, as well as the use of radium solution administered by mouth?\n55.\nIs it not a fact that they recommended as a standard dosage, where radium was to\nbe administered by mouth, anywhere from 2 to 6 micrograms daily?\n56.\nIs it not a fact that they would not list or recognize any product as having any\nbeneficial properties which would contain a dosage of less than 2 micrograms of\nradium element or its equivalent in radon daily?\nPage -6-\n57.\nIs it not a fact that in all probability a dosage taken daily of 6 micrograms\nwould contain more than could possibly have been absorbed by the operators who\npracticed the habit of pointing brushes with their lips?\n58,\nIs it not a fact that New and Non Official Remedies did not specify any maximum\ndosage or any dosage which might prove injurious?\n59.\nIs it not a fact that from New and Non Official Remedies one would have been justifi ed\nin prescribing the use of radium chloride by mouth over prolonged periods of time -\nsay from 6 months to & year, the dosage varying anywhere from 2 to 6 micrograms per\nday?\n60. Is it not a fact that probably such amounts have been administered, and that as far\nas you know no deleterious effects, either current or latent were recognized?\n61. Is it not a fact that the dangers of large quantities of radium have been récognized\nsince its early use?\n62. In this connection may I ask if you are familiar with the use of radium in the deep\nray therapy?\n63. Are you familiar with the pressutions necessary and recommended in the handling of\nradium for this purpose?\n64. Such precautions have been recommended by the British X-ray and Radium Protection\nCommittee, Bureau of Standards Dept. of Commerce X-ray and Radium Protection,\nMottram, Desjardines, and others.\n65. Are you familiar with any or all of the effects large amounts of redium and radio-\nactive preparations have produced, some of which may have been deleterious,\ndescribed by Cameron; Carmen; de Courmelles; Gudsent & Halberstaedter; Jaulin:\nLarkins: Lazarus Barlow; Lasarus; Loeb: Reitter: Russ; Chambers & Scott; Weil;\nWeil & Lacassagne.\n66. Do the recommendations of the British X-ray and Redium Protection Comm. etc., or\nthe men who have described the biological effects of large amounts of radium in any\nway apply to the internal use of radium in doses usually administered?\n67. Is not the administration of radium internally, either intravenously, intramuscular-\nly, etc., or per os, entirely separate and apart from the use of large amounts of\nradium radiation? in, deep ray work, where the effects are due primarily to the beta and gamme\nPage -7-\n68. Is it not a fact that the principal beneficial effects that have occured from\nthe internal use of radium may be ascribed to the alpha radiation?\n69. Has there ever occured anything in the literature with regard to the protection\nand precautions to be exercised in the handling of radium such as has been adminis-\ntered internally, let us say up to 100 micrograms of radium element?\n70. Will you describe what in your opinion constitutes a large enough quantity of\nradium that precautions recommended by the British X-ray and Redium Protection\nComm.; etc., should be exercised.\n71. Let us assume for & moment that at the time we employed operators engaged in the\napplication of self luminous material to clock dials etc., that an operator was\ngiven at one time a maximum of 2 grams of zinc sulphide, and such 2 grams contained\n& maximum of 60 micrograms of radium element, would such an amount have been\nsufficient in your opinion that it would have been necessary to exercise the pre-\ncautions outlined by the British X-ray and Radium Protection Comm.; etc.?\n72. Let us assume that an individual should have ingested radioactive materials as was\nclaimed by those employed in our plant, and that they retained this material for\na prolonged period of time, would that not be contrary to expectations, in view\nof the literature relative to the elimination of radioactive materials?\n73. Is it not & fact that individuals who have unduely retained this material and not\neliminated it in the usual manner probably present some idiosyncrasy which is not\ncommon to the average individual?\n74. May not this idiosynerasy be of such a nature that the person's normal health was\njeopardized, even though they had not been exposed to radioactive materials in &\nmanner whereby it was possible for them to ingest it?\n75. Is it not probable to assume that in the first place such individuals as unduely\nretained this material must have been suffering from a lack of proper functioning\nof their excretory organs?\nPage -8-\n76. Does it not appear to be reasonable to assume that any individual who was in mormal\nhealth and one whose excretory organs were functioning properly, and who obtained\nthe proper amount of daily exercise and otherwise in good health would hot have\nretained this material over such prolonged periods of time?\n77. Are you familiar with the work of Allen, Bowing and Rowntree, in Vol. 86 p.p. 164\nto 168 of the Journal of the A.M.A., 1927 \"On the use of radium in internal\nmedicine\".?\n78. With what institution are these men connected?\n79. Did they forcast in their article any possible deleterious effects occuring from\nthe internal use of radium?\n80. Are you familiar with the work of Dr. Hugh Mackay in the Canadian Medical Ass.Journal\nof 1926, Vol. 16, P.P. 142 to 144, on \"Schleroderma and its Treatment by Radium,\na preliminary report\"?\n81. With what institution is Dr. Mackay connected, and in what capacity?\n82. Is it not a fact that he used radium internally and in appreciable amounts?\n85. Did he forcast or note any untoward effects from the use of this type of medicine?\n84. Are you familiar with the work of R. H. Stevens, occuring in the Amer. Journal of\nRoent. and Ra. Therapy, Aug. 1926, on the\"use of intravenous injections of radium\nchloride in some of the malignant lymphomata\"?\n85. Did Dr. Stevens use radium chloride in appreciable amounts in the cases reported?\n86. Is it not a fact that Dr. Stevens did not note any untoward effects or predict\nthat any might occur from this type of medication, although he used it over\nshort and prolonged periods of time?\na. Is it not a fact that the health of many people has been jeopardized and to some\nextent sacrificed in the development of our knowledge pretaining to the use of\nX-ray and radium for deep ray therapy before complete knowledge as th the physical\nproperties and possible injurious effects which might accrue in the handling of these\nrather new types of radiation were established?\nb. Is it not a fact that even at the time that such injuries occured that it was\ncommonly believed all precautions were taken which would protect operators handling\nor working with these types of radiation from any possible injuries?\nC. Is it not a fact that those who allowed operators to handle the material to an\nextent whereby their health was injured were not negligent or liable in view of the\ninformation which was known or available at that time?\nd. Is it not a fact that the same situation applies to the deleterious effects accru-\ning to the health of individuals where automatic refrigeration was used with\nmethyl chloride as the refrigerant?\ne. Is it not a fact that those who countenanced the use of methyl chloride for such\na purpose could not be considered as having unduely exposed those who became\nafflicted in view of the fact that at that time a small amount of methyl chloride\nwas not proved to be deleterious or was not known to produce effects as were later\nrecognized?\nIs it not a fact that the health of many people has been jeopardized and to some\nextent sacrificed in the development of our knowledge pretaining to the use of\nX-ray and radium for deep day therapy before complete knowledge as to the physical\nproperties and possible injurious effects which migh accrue in the handling of these\nrather new types of exatilished\nIs it not a fact that even at the time that such injuries occured that it was commonly\nbelieved all precautions were taken which would protect operators handling or working\nwith this etypeSof radiation from any possible injuries.\nIs it not a fact that those who allowed operators to hand the material to an extent\nwhereby their health was injured were not negligent or liable in view of the information\ndeveloped at that time. which war hnown ovarailable N at that time\nIs it not a fact that the same situation applies to the deleterious effects accnuing\nto the health of individuals where automatic refrigeration was used with methy 1 chloride\nas the refrigerant.\nIs it not a fact that those who countenanced the use of methy 1 chloride for such a\nprupose could not be considered as having unduely exposed those who became afflicted\nin view of the fact that at that time a small amount of methyol chloride was not\nproved to be deleterious or was not known to produce effects as were later recognized.\namm/or the prepen of this quent such\nsuch faits\nor\nAss.\nAre you familiar with the work of Hugh McKay in the Canadian Medical/Journal\nof 1926, Vol. 16, pgs. 142 to 144, on Sclèroderma and Its Treatment by Radium,\na preliminary report.\namin\nWith what institution is Dr. MacKay connected and in what capacity\nIs it a fact that he used radium chloride internally and in appreciable amounts.\nDid he forcast or note any untoward effects from the use of this type of medicati\nAre you familiar with the work of R. H. Stevens, occuring in the Amer. Journal\nof Roent. and Ra. Therapy, Aug. 1926, on the use of intravenous injections\nof radium chloride in some of the malignant lymphomata.\nDid Dr. Stevens use radium chloride in appreciable amounts in the cases reported.\nIs it not a fact that Dr. Stevens did not note any untoward effects or predict\nthat any might occur from this type of medication over very short and prolonged\nperiods of time.\nallhough"
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