Grabherr Silke - Atlas of Postmortem Angiography

During the nineteenth century there was considerable scientific interest in passing electrical currents across fluids, and this was pioneered by Michael Faraday at the Royal Institution in London. These fluids could be liquids or gases, and as the century progressed there was an increasing ability to produce a progressively higher vacuum in a glass bulb.

In 1895 Wilhelm Conrad Rntgen, who was a 50-year-old physics professor at the University of Wrzburg in Germany [], made his classic experiment on the afternoon of 8 November. Rntgen was using a covered Hittorf-Crookes tube (an evacuated glass bulb), and he observed the fluorescence of a screen at a distance. This was the origin of what was to be called fluoroscopy.

The famous radiograph that Rntgen made of his wife Berthas hand was taken on 22 December 1895, and Rntgen delivered his preliminary report On a New Kind of Rays ( ber eine neue Art von Strahlen ) to the Physical-Medical Society of Wrzburg on December 28th 1895 for publication in their proceedings []. Although at the time this discovery could be seen as entirely unexpected, with hindsight we can discern a certain inevitability about it.

The news reached the scientific community in the first week of 1896 by two main routes []. First, Wilhelm Rntgen had sent reprints of his paper and samples of his radiographs to his physicist colleagues throughout the world. Second, most of the public heard of the discovery through the daily newspapers from foreign correspondents who had picked up the news of the discovery from the Vienna paper Neue Freie Presse . The papers editors son was a young physicist colleague of Franz Exner, another friend of Rntgen who had received a reprint of the first communication. Although the short newspaper reports of January 1896 were factual and contained limited associated commentary, their significance was not lost on those who were familiar with recent advances in experimental science. No previous scientific discovery had such a dramatic reception as that which greeted Rntgens work. The popular press, the world of science, and the medical profession reacted with a mixture of amazement, incredulity, and applause.

Although the first radiograph that Rntgen obtained was that of the hand of his wife Bertha, he soon realized that radiography could be used in other areas. Other items he radiographed included a coil of wire, a box of weights, and the door of his laboratory. These observations were to have great significance for forensic radiology and for nondestructive testing. In the summer of 1896, Rntgen took a radiograph of his shotgun, which he sent to Franz Exner in Vienna.

Rntgen was honored with the first Nobel Prize in physics awarded in 1901.

It is now quite difficult for us to understand the complete astonishment with which the discovery of x-rays was greeted by the general public. However, there was something decidedly macabre about being able to visualize the bones of the body during life, and radiography became a memento mori, a reminder that we are mortal and that we all one day will die, as shown in the bookplate of the pioneer Frederick Melville (Fig. ). In the modern world we are now so used to seeing medical images in contemporary media that the sense of fear is considerably less marked. Prior to medical imaging the inside of the body was seen only in the graveyard, battlefield, or the operating theater.

There were many pioneers in the early days of radiology. The pioneer use of radiology is particularly well illustrated in the work of Charles Thurstan Holland.

In the paper X-Rays in 1896 by Charles Thurstan Holland [], he described his radiologic work in 1896. He was a pioneer radiologist in Liverpool in the United Kingdom and was the President of the First International Congress of Radiology held in London in 1925. The work that Holland did in that first year and with his primitive apparatus is quite remarkable. His interest in radiology was attributable to the encouragement of the orthopedic surgeon Sir Robert Jones.

In practice many of the issues confronting postmortem imaging are the same as those encountered with radiography during life. The principles involved in both cases are similar. It is easy for us to think that the simple plain film images obtained in those early days must have been easy to interpret compared to the rather more complex three-dimensional images that we see today. In reality nothing could be further from the truth. Holland gives an excellent account as to exactly how difficult image interpretation was in those early days. As an example, on June 16 1896 he radiographed the forearm of a boy and demonstrated bone necrosis and bone loss. Holland said that this case opened our eyes to the big question of interpretation. Although the changes were gross, we were all wondering as to what it all meant. He radiographed a Potts fracture of the ankle and looked at the radiograph with Sir Robert Jones. They spent a long time looking at the images and again were wondering what it all meant. Whether imaging the living or the dead, the images obtained were and continue to be confusing. What is obvious to us retrospectively is not quite so obvious prospectively.