ROENTGEN RAY INTOXICATION : I. UNIT DOSE OVER THORAX NEGATIVE-OVER ABDOMEN LETHAL. EPITHELIUM OF SMALL INTESTINE SENSITIVE TO X-RAYS.
Roentgen radiation of the thorax (abdomen shielded) in dogs, even with large doses (up to 512 milliampere minutes), gives no clinical evidence of intoxication. There may be a transient leucopenia and a slight rise in urinary nitrogen. Roentgen radiation of the abdomen (thorax shielded) in dogs, with a dose of 350 milliampere minutes, will almost certainly cause a fatal intoxication. Smaller doses may be survived but usually with signs of gastrointestinal intoxication. This lethal intoxication due to abdominal radiation presents a remarkably uniform clinical and anatomical picture. There is a latent period of 24 to 36 hours, during which the dog is perfectly normal clinically. The 2nd day usually shows the beginning of diarrhea and perhaps some vomitus. The 3rd and 4th days show progressive intoxication with increasing vomiting and bloody diarrhea until the dog becomes stuporous. Death is almost always on the 4th day. Anatomically the only lesions of significance are to be found in the small intestine. The epithelium of the crypts and villi shows more or less complete necrosis, and this condition may involve almost all of the small intestine. The epithelium may vanish completely except for a few cells here and there which have escaped and are often found in mitosis, probably an effort at repair and regeneration. We are forced to the conclusion that this remarkable injury of the epithelium of the small intestine is responsible for the various abnormal reactions and final lethal intoxication which follow a unit dose of Roentgen radiation over the abdomen of a normal dog. This sensitiveness of the intestinal epithelium to x-rays is not appreciated and should be given proper consideration in clinical work.
Warren
S L
SL
The George Williams Hooper Foundation for Medical Research, University of California Medical School, San Francisco.
Whipple
G H
GH