Radiography (2005) 11, 123e129

GUEST EDITORIAL

Archibald Reid Memorial Competition*

In February 2005 three papers were publisheddescribing the proposed revisiting and researchingof information contained in the early journalseRadiography. The period 1935e1950 is currentlybeing researched and is turning up some veryinteresting material. In cataloguing the informa-tion available, several papers were located docu-menting the content of various Memorial Lecturesand competitions. This month’s edition sees ac-counts taken from some of the Archibald ReidMemorial Competitions. This started in 1929 andfinished about 18 years ago (1987). A telephoneconversation with Jill Smith, at the College ofRadiographers, indicates that some of the MemorialLectures have been included in the programmes ofUKRC and will continue to do so. The Archibald ReidMemorial Competition, however, has been sus-pended. A list of the recipients of the medal, from1929e1968 is published together with a synopsis ofpublished papers between 1935 and 1945 (part 1,part 2 will be published in the May edition). If thereis an omission it is because no evidence of publi-cation of a particular prize winning thesis could befound, for example 1929 to 1933 and 1936 to 1938.Publication may have taken place elsewhere butcould not be traced in copies of Radiography.

All the Memorial theses published have beensummarised and items of interest have beenhighlighted. It has been edifying and humbling tosee what the early pioneers achieved and whatforesight they had. Much of our current practice isunderpinned by their early day research. Obviouslysome things have changed but it is surprisingthat as early as the 1930’s and 1940’s thingslike training, further education, research and de-partmental administration were being described,

* The language and phraseology used in this paper is that usedby the writers when they published their papers. It was feltinappropriate to change it.

1078-8174/$ - see front matter � 2005 Published by Elsevier Ltd odoi:10.1016/j.radi.2005.02.001

albeit in simplistic terms befitting the early days ofthe profession. Some of the recipients of thisaward went on to become prominent members ofthe profession and older radiographers will re-member them. However the more junior membersof the profession will have seen if not used Clark’stext book Positioning in Radiography.

For anyone wishing to visit these early editionsin the British Institute of Radiology library, theopening hours are Monday, Wednesday and Friday9.00 a.m. to 5.00 p.m. and Tuesday and Thursday10.00 a.m. to 6.00 p.m.

In the February (2005) edition of the journal theidea of cataloguing important details from ourpast, was introduced. There were several annualcompetitions and lectures and some of the latterhave been attached to the programme of theAnnual Conference (UKRC). One of these was theArchibald Reid Memorial Competition. Below isa list of winners from 1929, however, not all theseswere published.

1929 Mr. WE Smith 1948 Mr. OM Alexander1931 Mr. RM Leman 1949 Mr. JE Forsyth1932 Miss. D Marsh 1950 Miss M Gange1933 Mr. RM Leman 1951 Mr. R White1934 Mr. W Watson 1952 Miss SM Stockley1935 Miss. VM Scott 1953 Miss. R Blackman1936 Miss. MS Milln 1955 Mrs. J Arblaster1937 Miss AMV Ash 1956 Mr. TA Longmore1938 Miss HE M Glasgow 1957 Mr. DF Owen1939 Miss. M Newey 1958 Miss BL Tucker1941 Mr. TC Hall 1959 Miss MO Chesney1942 Mr. C Ashwin 1960 Mr. D Graham1943 Mr. B Quinn 1962 Miss. JME Harper1944 Miss. E Robinson 1963 Miss. FA Paris1945 Miss. J Hamilton-Martin 1964 Mr. HB Bentley1946 Mr. K Cruickshank 1966 Miss. DN Chesney1947 Mr. HA Calder 1968 Mr. JL Harris

n behalf of The College of Radiographers.

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Rules for the Archibald Reid MemorialCompetition

The competition is open only to members of theSociety whose subscription is paid for the currentyear, but is not open to those who gained the medalpreviously (it is not known how RM Leman receivedit twice). Theses received not later than November1 will be accepted for consideration, but theCouncil does not bind itself to make an award.The decision of the Council will in all cases be finaland binding. The award will consist of the ArchibaldReid Memorial Medal and an honorarium of fiveguineas (published 1936). Theses should not exceed4000 words in length and should be typewritten andaccompanied by explanatory drawings, diagramsand prints, where necessary. The Society reservethe right to publish any thesis presented whether itbe awarded a medal or not (see Rule 68). Thesesshould be submitted under a nom de plume anda sealed envelope containing the name and addressof the author, with the nom de plume written onthe envelope, should be enclosed with the Thesis.Entries should be addressed to The Society ofRadiographers, 32, Welbeck Street, London W 1and the envelope must be marked Reid thesis.

The first published thesis (in Radiography) ap-peared in 1936 and this was the 1934 winningsubmission, by W Watson, ‘‘The making of di-agnostic radiographs e 1, with and without in-tensifying screens.’’1

In this paper Watson discusses definition and theeffect of intensifying screens upon it, gradationand when to use intensifying screens. A secondpart follows in Volume 2 (20) 113e122, in whichthe making of radiographs is described, with andwithout PottereBucky diaphragms.2 The PottereBucky diaphragm is described and films of a bariumexamination of the gastro-intestinal tract arepublished. There are also illustrations of thestroboscopic effects of moving grids.

The winning thesis in 1935 was ‘‘The care andcomfort of patients in Radiography and X-raytherapy.’’ It was presented by a Miss VM Scott ofSt. Bartholomew’s Hospital in London.3 ‘‘CARE ofthe patient embodies thought for and attention tothose details which affect the bodily well-being ofa patient from the medical point of view,’’ sobegins the second paragraph. Then follows titlessuch as Instructions, Splints and dressings, Asepsis,Emergencies, Temperature, Accidents, Ventila-tion, Food and drink, Radiation and Ward cases.

‘‘COMFORT of the patient is a wide term anda vastly important one, in that it embodies allthat thoughtfulness and those innumerable details

which affect so materially not only the physicalcomfort, but also what is often of even greaterimportance, the mental ease of the patient.’’ Thissecond definition is followed by sub-headingssuch as manner, children, case-notes, neatnessand cleanliness, the radiographic and treatmentrooms, dental work, dressing rooms, sickness,physical comfort, temperature, waiting patients,lifting patients, during treatment and radiography,relaxation and handling patients. When ‘‘Care ofthe patient and Hospital Practice’’ became a sub-ject in the Diploma syllabus in the 1960s, many ofthese headings appeared with elaboration.

A Miss M Newey from Leicester was the winner in1939 on the topic of ‘‘Soft tissue radiography.’’ Shebegins by defining ‘‘soft tissue radiography,’’ ‘‘. inits widest application, includes the radiography ofany part(s) of the body not included in the skeletalframework.’’4 Discussion follows about the variousorgans and glands which come under the heading ofsoft tissue. Then the X-ray generator, exposurefactors, useornon-useof a PottereBuckydiaphragmor Lysholm grid are also mentioned. Each area isdealt with under headings, radiography of regions ofthe trunk, renal tract, gall bladder, liver and spleen,and oesophagus. The trachea, thyroid gland, parotidgland and tongue are mentioned. Tumours of theface and radiographs of a cavernous haemangiomaare included. There then follows radiography of theextremities, calcification, soft tissue radiography inplace of and in conjunction with the normal andradiographs of examples are shown. In the 1940journal there is a picture of carcinoma of the breast[Radiography 1940 6 (62) 39].

As the war years progressed the paper availablefor the journal became of lesser quality but itcontinued to be published. In 1942 the thesis for1941 was published. This was ‘‘The significance ofPhysics in Radiography and Radiotherapy,’’ won byTC Hall.5 He says ‘‘Radiographers manipulatea most complex and highly developed physicalapparatus and are doing every time they makean X-ray exposure, a complicated if routine,experiment in applied physics.’’ ‘‘Certain Surgeonsand Physicians, quick to see the possibilities ofRoentgen’s discovery, brought their patients to thephysics laboratories for radiographs of variousinjuries.’’ ‘‘Thus Radiography was born in thephysics laboratories’’ says TC Hall (a radiogra-pher). After discussing the unreliability of theearly X-ray tubes he moves on to the electromag-netic spectrum using a diagram to show thewavelength of various colours and the response ofthe fluorescent screen, intensifying screens, pho-tographic plates and the human eye. Fluorography,

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high speed films and the photographic effects of X-radiation are all discussed. He/she then turns toradiotherapy and the effects of X-rays on tissues.‘‘The whole science of radiography is based uponthe physical findings that X-rays, because of theirshort wavelength, are able to penetrate matter,but are differently absorbed by different materi-als.’’ ‘‘Absorption and scattering are importantfactors in radiography and radiotherapy.’’ Furtheron in the paper he discusses half-value layers ofaluminium for various wavelengths, (in those daysin Angstrom units). He/she refers to the half-valuelayer being adopted by the ICRU in Paris in 1931 asa procedure for measuring quality of radioactivesubstances and their use in radiotherapy. The workof Sievert (1932), in investigation of the distribu-tion of radiation also receives mention. Finally thevarious ‘‘Protection Committees and their dutiesare included.’’

The successful thesis for 1942 was ‘‘Economy inradiography e its uses and abuses’’ by C Ashwin.6

The opening remark ‘‘It is not unusual for theX-ray department to be regarded as the mostexpensive section in a hospital,’’ still appliestoday. Pharmacy and Radiology are amongst themost expensive departments. For the purpose ofthis paper the author divided it into five sections;

(a) Technical (maintenance etc.)(b) Radiography(c) Processing(d) Clerical(e) Staff.

In section (a) the dealings with non-shockproofinstallations are considered. The author also recom-mends, ‘‘the expenditure of a small sum annually,for regular inspections and maintenance by a qual-ified X-ray engineer,’’ as a good investment.

The opening remark in section (b), ‘‘a goodradiographer is born e not made,’’ is worth noting.Ashwin goes on to give examples of where a radiog-rapher can make use of particular pieces of equip-ment in the interests of economy. Examples are alsogiven of where there is a ‘‘waste of energy (elec-trical and physical) but is of no assistance in theproductionofagoodqualityfilm.’’Useof thecorrectsize of film for a particular examination is cited as aneconomy. ‘‘Utilizing full size (15! 12) films, theminimum film cost is eleven shillings and six pence(10 shillingsZ 50p), if half size (15! 6) are used theminimum, cost is six shillings (about 30p).’’

There is a brief mention of the merits of X-rayfilms versus X-ray paper.

Turning to section (c) the author deals withprocessing. He says ‘‘Many excellent radiographsare spoiled in the darkroom.’’ He advocates that

‘‘As much attention should be paid to the layoutof a darkroom as to the main X-ray room.’’‘‘Unfortunately many of the smaller hospitalsendeavour to economise by converting a disusedpantry, larder or cubby-hole under the stairs intowhat they fondly term the darkroom.’’ ‘‘Theresults of such economy are soon apparent insplashed and stained intensifying screens, ruinedclothes, dirty walls and streaky and badly washedfilms.’’ It would seem that silver recovery was notfelt to be a worthwhile or economic practice atthat time ‘‘although salvage of sludge from thefixing tanks (with a view to ultimate recovery ofthe silver content) is hardly a form of practisingeconomy.’’ ‘‘The sale of old films, on the otherhand, may prove profitable.’’ The section (d),Clerical is dealt with next and focuses on filingand recording. A card index system is thought to bethe ‘‘most economical and convenient method ofrecording.’’ ‘‘Storage envelopes, of a size to takethe largest film in use, and strong enough to holdat least six films, represents the highest econom-ical factor.’’ ‘‘Steel filing cabinets, although con-venient, are not essential in the average X-raydepartment.’’ ‘‘.the radiographer should arrangefor the erection of wooden racks or shelves roundthe walls of the office (if available) or along twowalls of the X-ray room.’’ There could not possiblyhave been any idea of what a storage of X-raysfilms was to become in the future.

Finally section (e) Staff. ‘‘The minimum numberof individuals that may be economically employedin an X-ray department is related to the number ofpatients attending daily.’’ This is probably a moresimplistic relationship/equation than would beapplied today!! However, for the time, 1942, theauthor proposed ten patients for every member ofstaff. These figures were arrived at on the basis ofthe following data.

‘‘Total number of patients attending X-ray de-partment for 1939, 1940, 1941 is 44,763.’’ Theaverage yearly attendance is 14,921 (say 15,000).The average daily attendance 50. Therefore thenumber of staff required is 15. X-ray departmentmanagers may care to apply this formula to theircurrent departmental figures. The allocation ofduties in the department was suggested. FirstRadiographer e responsible for all ‘‘heavy’’ di-agnostic cases i.e. barium meals, enemas, spineand skull work including theatre operations. Sec-ond Radiographer e all ‘‘light’’ cases i.e. minorcasualties and ward work. Assistant will generallyassist both first and second radiographer in carry-ing out examinations, preparation of barium mealsand enemas, preparation of trays for intravenousinjections and retrograde pyelography. Darkroom

126 Guest Editorial

assistant e responsible for all processing andmaking up solutions. Filing clerk e in charge ofall records indexing, appointments, enquiries andattending upon the radiologist.

‘‘From consideration of the above, especially inregard to week-end duty and reasonable hours ofwork, it will be seen that the economical minimumfor any X-ray department is a staff of 2.’’

Sergeant Brian Quinn of the Royal Air Force wasawarded the Memorial Medal for 1943. The thesisentitled ‘‘The radiography of young children andinfants’’ and was presented in three main sec-tions.7 Section (1) the psychological factors in-volved in child radiography, (2) two tablesindicating some of the commoner abnormalitiesand conditions encountered in this work and (3)the actual radiographic principles involved, a briefmention being made of a few special techniques.

Psychological factors are discussed under thefollowing headings: fear, loneliness, age groups,parents, punctuality and alleviation of pain.

Fear of the unknown and of the equipment to beused to produce the radiograph(s). Lonelinesscomes from ‘‘being suddenly removed fromhome,’’ and bewilderment in strange surround-ings. Under age groups the author deals with twomain divisions, the infant and children who aremore mature, both physically and mentally.

‘‘Young patients will be more at ease whenexamined in the presence of a parent, the feelingof lack of support being one of the big factorscausing a display of temper.’’ However, the authoragrees that there are occasions when the parentshould remain in the waiting room. ‘‘Stress shouldbe laid upon the need for punctuality, especiallywhen it is intended to carry out an investigationrequiring the presence of a medical attendant, for itwill be found to dispel the vague forebodings whichthe preparations of the X-ray room, however osten-tatiously made, may cause in the infants mind.’’

‘‘The presence of pain, will of course, alwaysdistress the child and in many cases it is beyondthe power of the radiographer to alleviate thesuffering.’’ The author feels that it is of greatvalue if the radiographer understands the paindirect and indirect, associated with the radiogra-phy of children.

Quinn then moves to the ‘‘More Common Ab-normalities’’ and two tables are provided. Table 1‘‘Congenital Abnormalities’’ and table 2 ‘‘AcquiredAbnormalities.’’

Under the heading of Radiographic Principlesthere are several sub-headings. Bone technique eit is stressed that fine detail is necessary in theradiograph to produce accurate diagnosis. The useof intensifying screens is felt to cause image

diffusion because of the large grain size of thescreen emulsion. PottereBucky diaphragms areseldom required in the radiography of infants.Favourable results will be achieved if the infantor child is made comfortable. The relative densityof the bone structure and the age of the patient isnot always a reliable guide to the exposure factorsrequired.

Comparative films is another sub-heading. Thisrefers to the confusion which sometimes arisesfollowing injury to the epiphyses. It is recommen-ded that reference should be made to a chartshowing the normal epiphyses and the ages atwhich they normally unite. In cases of suspectedepiphyseal damage the normal limb should also beexamined for comparison. This, of course, is nolonger recommended routinely under RadiationProtection legislation the RCR Guidelines advise‘‘not recommended routinely, if in doubt seekradiological advice.’’8 The age of the child is ofgreat importance to the radiologist so it should beshown correctly on the request card. Radiographyof a normal limb should always be undertaken forchildren with congenital abnormalities. ‘‘Caseswhich show a gross deformity may not lendthemselves to routine positioning.’’

Under the sub-heading of plaster and splintingthe author describes the difficulty of obtainingtrue antero-posterior or lateral views especially inthe case of fractures of the femur where the limbmay be plastered from hip to toe.

With regard to skull injuries special attention isrequired because the child may need to lie flat.For lateral views in cases of suspected depressedfractures of the skull the head should notbe turned onto the affected side on the table.A horizontal X-ray beam lateral projection isrecommended.

Radiography of the elbow joints receives specialattention, highlighting supra-condylar fracturesand dislocations and suggesting appropriate pro-jections.

The author indicates that ‘‘Examinations ofthe chest, do not, as a rule present many un-usual obstacles. The chief difficulty is usuallyexperienced in obtaining a film with lungs fullyexpanded.’’ If the child is sobbing or restless‘‘A far more economical measure is to requestthat the child be submitted for the examination onanother occasion.’’ The use of contrast media isdiscussed initially, Lipiodol being introduced viathe trachea into the bronchi. The most commonLipiodol examination undertaken in young childrenis investigation of a sinus from old empyema.Lipiodol was also injected into sinuses caused bysuch bone infections as chronic osteomyelitis.

Guest Editorial 127

The use of contrast media for intravenouspyelograms and retrograde pyelograms does notpresent undue problems for the radiographer.Similarly the use of barium sulphate for enemasdoes not present any great difficulty in youngchildren. If there is difficulty in persuading a childto ingest a barium meal ‘‘sweet flavouring’’ es-sences such as syrup of lemon is added.

With regard to ‘‘screening’’ and fluoroscopy,warning is given that ‘‘children are nervous ina darkened room.’’

Special mention is made of children and foreignbodies in the respiratory and alimentary tracts.

A Scottish radiographer from Musselburgh wasthe competition winner in 1944, a Miss ElizabethRobinson. The title of the thesis was ‘‘Organisationand administration of an X-ray department, eitherdiagnostic or radiotherapeutic, so far as it affectsthe radiographer.’’9

In her introduction the author says, ‘‘thisbranch of medical science (X-ray department),should be planned, organised, and maintainedwith the greatest possible regard to efficiency,economy, and convenience.’’ ‘‘By choice it shouldbe centrally placed with regard to hospital wards,and should be easily accessible from the medicaland especially the surgical out-patients depart-ments.’’ ‘‘It should be situated, if possible, on theground floor convenient for lifts and ambulancesand if housed in an outside block, it should, iffeasible be connected to the main building bycovered runways.’’ Subsidiary departments arementioned for surgical out-patients (includingfractures and orthopaedic clinics). A portable unitis suggested for ward work and operating theatres.‘‘The decision to install and staff subsidiary de-partments rests, of course, with the radiologistand the Hospital authorities; but the smoothrunning, usefulness and preparedness of thesedepartments depend to a great extent on thebusinesslike methods of the radiographer incharge.’’ Under the heading of Staffing it issuggested that there should be separate staff fordiagnostic and treatment work. Radiographers arerecommended to familiarise themselves with thevarious plants, with possibly specialisation only inareas such as skull or chest work.

In a small department ‘‘all recording comesunder the care of the radiographer, and oftenfiling, indexing and even correspondence.’’ He(the radiographer) frequently has to be, as wellas an X-ray worker, a darkroom boy, an office help,a filing clerk, a typist and a telephonist.

General routine receives a separate heading andcovers areas such as requisition forms, details tobe recorded on a request card, transfer of ward

patients to the department and so on. It isadvocated that sets of instructions should be drawnup and circulated to wards for all instances wherepatient preparation is required. Various otherduties for the radiographer are also mentioned.

The darkroom has a section recommendinggood organisation and setting out details of thelayout and use. Recommendations for mixingprocessing chemicals and strict adherence to themanufacturers instructions are advised. Avoid-ance of pollution of solutions is stressed andscrupulous cleanliness to avoid spoiling films.Finally in this section care of intensifying screensis dealt with.

Office work and methods of filing are outlinedand organisation of the office staff is recommen-ded to ensure efficiency. A system of cross-refer-encing of files with suggested headings e name(alphabetically), part X-rayed, diagnosis and geo-graphical reference is laid out and an interestingcomment ‘‘.this last category is especially usefulfor follow-up work, and in any department in-terested in research.’’ So radiographers had an eyeto research in the 1940s.

‘‘In a large X-ray centre much valuable materialis assembled, and part of the departmental plan-ning may consist of collecting and indexing a filmmuseum.’’

‘‘Most of our large X-ray centres are trainingschools for radiographers, and an important fea-ture is the regularity with which lectures areattended and the facilities given to students forpractical work.’’ ‘‘It should be realised thatstudents should be given time to study, to writeup notes, to ask questions.’’ ‘‘The radiographer incharge’’ (superintendent) is awarded this honourby the author.

Another job for the radiographer is keepingof stock and inventory. ‘‘Articles such as angleboards, head clamps, sand-bags, cassettes, printtrimmers, intensifying screens, spirit levels,localising appliances and lead markers etc. shouldbe checked periodically.’’ Stock taking, recordkeeping, ordering supplies all fell to the radiogra-pher. ‘‘In some cases even invoices come to theradiographer for checking before being passed forpayment.’’

Economy is another section dealt with in thispaper. ‘‘All waste of time, not only on the part ofdepartmental personnel, but of all nurses, porters,and orderlies should be avoided.’’ ‘‘Time spent incleaning apparatus is well spent.’’ Within thissection, economies desirable in wartime (1944)are identified.

The penultimate section deals with healthprecautions such as periodic blood counts, and

128 Guest Editorial

may be quarterly, half-yearly or annually. Theradiographer is responsible for receiving the re-ports from the Haematologist and filing them. Forhealth and safety reasons (‘‘a safe and healthydepartment’’), aprons, gloves etc. (lead rubber)should be worn and kept in order when not in use.‘‘All X-ray apparatus, X-ray couches and standsshould be properly earthed.’’

In summing up the author says ‘‘The perfectadministration is where the maximum efficiency isobtained from the plant installed, waste avoided,and costs kept as low as is compatible with thebest results to the patient, the hospital and thesatisfaction of the personnel.’’

Charts of ‘‘three simple record forms for mini-mum requirements’’ are illustrated.

Miss Joan Hamilton-Martin was the award winnerin 1945 the year the war ended. The paper is dividedinto part 1 obstetrics and part 2 gynaecology eachwith sub-divisions.10 Within the first two paragraphsthe patient care and well-being is stressed.

‘‘For the best results there should be completeco-operation between the obstetrician, patient,radiographer and radiologist.’’

‘‘In this first section the diagnosis of pregnancyand other examinations are discussed; the foetus,the use of opaque media, the maternal pelvis andfoeto-pelvic relationships.’’ First, there is the con-firmation of the diagnosis of an early pregnancy.A radiographic image (fig.1) shows a gravid uterus.‘‘.it (the gravid uterus), is not likely to bedetected before the 15th week owing to the poorcalcium content of the foetal skeleton.’’ There arethen three ‘‘first shadows to look for (a) the hair-like lines of the ribs, (b) the regular dots of thespine and possibly (c) the shadows of the skull andone or more of the long bones nestling low down inthe pelvis.’’

Other examinations which the obstetrician mayrequire are concerned with possible foetal abnor-mality, (a) multiple pregnancy, (b) hydramniospossibly involving hydrocephalus, inencephaly oranencephaly of the foetus. (c) the presence ofa dermoid cyst, fibroid, or tumour in addition tothe foetus.

Foetal death (clinically ‘‘small’’ uterus fordates), Spaldings’s sign, could also be seen onthe radiograph (overlapping of the cranial bones)was a reliable radiographic indication of foetaldeath. Foetal maturity could be demonstratedradiographically, by the presence of various bonesand their epiphyses. The cuboid and tibial epiph-yses were regarded as proof that the foetus was‘‘at term.’’ If a breach presentation was suspectedthe patient could be X-rayed at 32e34 weeks sothat arrangements could be made for version,

before the 36th week. Either a prone or a supineradiograph (correctly labelled), would enable theobstetrician to make plans for the delivery. Alateral projection of the patient’s pelvis wouldindicate the position of the head in relation to thematernal sacrum. The lie of the foetal spine in theprone or supine radiograph determined whichlateral view was undertaken. The four points ofconcern to the obstetrician were; the sacralpromentary, sacro-coccygeal articulation, symphy-sis pubis and ischial tuberosities. Seeing the foetusin relation to these showed if the head wasengaged and the plane of inclination of the pelvicbrim and the sacral arch.

The pregnant patient could also be radio-graphed to determine extra-uterine pregnancy.

The use of opaque media is described as beinghelpful in obstetrical radiography in detecting (a)the presence of urinary disturbances and (b) thepresence of placenta praevia.

Measurements were also made, by radiography,of the maternal pelvis and this was pelvimetry.Measurements could also be made, from radio-graphs, of the pelvic inlet, the mid-pelvic diame-ters, and the pelvic outlet. A lateral projection ofthe patient’s pelvis could also be obtained witha metal ruler positioned in the natal cleft. Radi-ography of the pregnant female became lesspopular following the publications of Stewartet al. and Court-Brown and Doll in the late 1950sand 1960s. These related to leukaemia in childrenexposed to ionising radiation in utero.11,12

The author goes on to describe the use ofradiography in gynaecology. ‘‘It is generally agreedthat the gynaecologist gains considerably fromradiography when he permits his patient to beinvestigated by utero-salpingography.’’ The pro-cedure was used as a means of investigatingsterility and in itself it could clear a blockedfallopian tube. The gynaecologist or the radiologistinjected Lipiodol into the uterus through a cannulaand radiographs were taken of the uterus, fallopiantubes, and abdomen. This procedure was usuallyundertaken under fluoroscopy. A full account ofwhich radiographs were taken and for what pur-pose, was recorded. Continuing with tubal anduterine abnormalities, abdominal masses and pel-vic diseases the author illustrates the uses ofradiography. Pictures of radiographic images ac-company the article and clearly show the proce-dures described. In conclusion the author stated‘‘.warning should be given that unnecessaryrepetition of lengthy exposure, such as are neededfor pelvimetry, are inadvisable, but applied inmoderation there should be no detrimental ef-fect.’’ (This was 1946, by the 1950s and 1960s there

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was evidence to the contrary and of course theadvent of ultrasound replaced ionising radiation inexaminations of the reproductive system).

References

1. Watson W. The making of diagnostic radiographs e 1 withand without intensifying screens. Radiography 1936;2(16):49e55.

2. Watson W. The making of diagnostic radiographs e 2 withand without PottereBucky diaphragms. Radiography 1936;2(20):113e22.

3. Scott VM. The care and comfort of patients in radiographyand X-ray therapy. Radiography 1937;3(27):36e42.

4. Newey M. Soft tissue radiography. Radiography 1940;6(62):29e40.

5. Hall TC. The significance of physics in radiography andradiotherapy. Radiography 1942;8(89):67e72.

6. Ashwin C. Economy in radiography e its uses and abuses.Radiography 1942;8(96):121e5.

7. Quinn B. The radiography of young children and infants.Radiography 1943;9(103):89e94.

8. RCR (2003) Making the best use of a Department of ClinicalRadiology. Guidelines for doctors Ed 5 RCR London.

9. Robinson E. Organisation and administration of an X-raydepartment either diagnostic or radiotherapeutic, so faras it affects the radiographer. Radiography 1944;10(120):89e93.

10. Hamilton-Martin J. Radiography e an essential aid inobstetrical and gynaecological practice. Radiography1946;12(137):50e5.

11. Stewart A, Webb J, Hewitt D. A survey of childhoodmalignancies. Brit Med J 1958;1:1495.

12. Court-Brown WM, Doll R, Hill AB. Incidence of leukaemiaafter exposure to ionising radiation in utero. Brit Med J1960;2:1539.

H.B. Bentley25 Calder Drive, Snaith, nr Goole,

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