Consider the fact that in 2012 it usually takes at least a decade before a new pharmaceutical can travel from first bench experiment to the chemist’s shop. A new medical device, particularly if a modification of an accepted design, can usually be deployed more quickly, but it’s still on the order of years from bench to bedside. New procedural techniques are faster still and are mostly limited by the reluctance with which any doctor will consider the possibility that someone else has invented a better way to do things – but such techniques are comparatively minor innovations usually only applicable to a narrow sub-discipline.

Within a year of Roentgen’s discovery, clinical radiography was being practiced all over the globe – here using a portable system at the fringes of the British Empire in India.

Now consider this. Roentgen made his announcement on December 28th, 1895. It had been reported in German papers by January 5th, in the rest of Europe by the 7th, and in America by the 8th or 9th. While a few of the stories and editorials were suspicious or outright mocking (“Why,” one London journal asked, would anyone “care to sit for a portrait which would only show the bones and rings on the fingers?”), the scientific community jumped on the report with amazing alacrity. By January 8th for inanimate targets (a metal razor) and by the 13th for human subjects, Roentgen’s work had been reproduced in Scotland (by Alan Swinton, who is probably the first person after Roentgen to take an intentional radiograph), and within weeks radiographs had been taken all over the industrialized world. (Although numerous claims for priority in America exist, the best documented was by Arthur Williams who, on January 27, obtained a radiograph at my medical school alma mater in New Haven, Connecticut. Incidentally, Harvard’s first radiograph was not taken until the 31st.) Perhaps more importantly, there was essentially no gap between the discovery of x-rays and their clinical application. In Germany, x-rays had been used to locate a shard of glass within a child’s hand by January 20th and on February 3rd at Dartmouth the first clinical American radiograph was used to visualize a child’s wrist fracture. Soon one could obtain an x-ray in every corner of the world.

On the night of February 3, 1896 young Edward McCarthy became the first American patient to have a clinical radiograph. The image, taken in the physics lab at Dartmouth, showed a fracture of his distal radius.

Within a month clinical medicine had been revolutionized. I imagine the response was a bit like what might happen today if someone announced that cancer could be cured using a twenty thousand dollar centrifuge. It might not be possible for every hobbyist to test the experiment in her garage – but even undistinguished scientists working at second or third rate institutions would be able to (and would be unable to resist the temptation to) start curing patients.

This 1896 cartoon from the British magazine, Punch, played upon tense Anglo-German relations by indicating that the new x-rays would allow the Kaiser to appreciate the strength of the backbone of the British people.

While researchers and clinicians obviously appreciated the significance of Roentgen’s discovery, it’s less clear what the nature of the popular response was – particularly since the most outlandish responses tended to be the best recorded. (Will future historians believe that most Americans blamed that diabolic rock and roll music for school shootings, or that one can’t get pregnant from rape?) Furthermore, the situation at least initially was complicated by Anglo-German tensions related to the ham-handed foreign policy of Kaiser Wilhelm who, on January 3rd, had sent the “Kruger Telegram” congratulating the president of the South African Transvaal Republic on the defeat of an ill-planned British raid. One cartoon in Punch, for example, suggested that the best use for these German x-rays was to allow the Kaiser to see the stern stuff of which the British John Bull was made. Other humorous suggested applications for x-rays included the detection of wine and whiskey glasses in the arms of baseball pitchers (standards of humor in 1896 were, apparently, not particularly high). Another belief (of uncertain popularity and seriousness) was that x-rays would allow unscrupulous oglers to peer beneath a person’s clothes and thus that laws would need to be passed to prevent x-ray usage in public, or that respectable ladies and gentlemen would need to bring back the medieval aristocratic prerogative of wearing metal armor.

“I’m full of daze,

Shock and amaze,

For now-a-days

I hear they’ll gaze,

Thru cloak and gown and even stays,

These naughty naughty Roentgen Rays.”

- From “When Physics Became King“

This 1896 cartoon illustrated just a few of the possible (hilarious) results of Roentgen’s discovery. My favorite are the armored bustles in the lower right corner.

While the modern mind, experienced with the x-ray technologies of airport screeners, imagines this Victorian anxiety as directed against the viewing of flesh, it also appears that some perceived the visualization of one’s skeleton as itself somehow unseemly. When first presented with an x-ray demonstration the Prince of Wales described it as “disgusting” and in the attached cartoon it is not the couple’s bodies on display, but rather their bones.

Within a year of Roentgen’s announcement the world also saw the creation of multiple societies and journals dedicated to the study and application of X-rays.

While we may never know the typical response of the “man-on-the-street” to Roentgen’s ray, we certainly know that of the business world: intense enthusiasm. The late 19th century was still the era of the snake-oil salesman (as is the 20th and 21st) and advertisements abound for examples of clothing (particularly undergarments) treated to “block x-rays,” or pills that contained x-rays and which could treat any of a wide variety of ills. There are no readily available data on how commercially successful these ventures were – but the sale of x-ray equipment quickly became big business.

The association between X-Rays and medicine was such that unscrupulous marketeers were able to profit by offering to include X-Rays in everything from pain relievers to floor cleaner. From “Radiographics, 2004″

The first radiographs and fluoroscopic studies were performed with research equipment that had previously been used by scientists studying cathode rays. While these apparatuses were not vanishingly rare, they were not in any way equal to the clinical demand. Over the next few years even backwoods hospitals and distant military infirmaries were equipped with x-ray equipment – an endeavor that made fortunes (Siemens, General Electric, and Philips have all been in the business from the beginning) and attracted the attention of industry’s brightest minds. Edison, for example, famously got in on the act with the development of a mass produced fluoroscopy unit (he is usually credited with the invention of the word – his second choice, apparently, after “vitascope.”). It was an exciting time as researchers and manufacturers experimented and tweaked in an effort to devise new applications and more refined technologies.

By 1900 the sale of x-ray paraphernalia to proto-radiologists was big business.

Sadly, it was also the period during which a dark side to these invisible rays was discovered.

This Norman Rockwell painting from 1947 depicts the idyllic physician – humane and comforting . . . and in the far right of his office is a radiography unit. Despite the dangers of radiology that had become evident in the early 20th century, it was (and continues to be) one of the most important tools in the fight against disease.