![]() If we want to analyze the initial use of the technology, how it was actually applied to patient care, one useful place to start could be in hospitals. By 1900, only 5 years after its invention, the use of the X-ray machine was widely described as being essential for clinical care, especially for making a diagnosis of foreign bodies and fractures ( 8).Īs appealing as “great moments in medicine” stories such as this may be, to understand the actual history of the uptake of the X-ray machine for clinical care is not nearly so simple. Fractures, too, were amazingly easy to identify with the new rays. While some parts of the body (such as the brain) were difficult to visualize with the new tool, numerous observers noted the ease with which foreign bodies (such as swallowed coins) could be located with new machine. ![]() Within the medical world, X-ray images were initially attempted for many disparate conditions. Because the equipment necessary to make an X-ray machine was cheap and the device was easy to use, X-ray machines were soon found in numerous locations, both medical and non-medical ( 7). Within the first year after its invention the X-ray was the subject of some 49 books and more than 1,000 articles (at a time when there were far fewer journals than we have today) ( 6). ![]() The sudden ability to see within the human body had a tremendous impact on almost every segment of society. It is difficult to overestimate the widespread impact of this singular event ( 5). He sent the image of his wife’s hand around the world on Christmas Day 1895 ( 4). ![]() These were rays about which Röntgen knew little, and thus he called them “X” rays. To do so he used rays that pierced the skin and revealed shadows of the bone beneath. Unlike some innovations in medical thought and practice that were created as the result of a sustained series of experimental interventions, or even discoveries that came about as the result of a rapid series of incremental changes, the invention of the X-ray machine came at the moment when a physicist named William Conrad Röntgen, working in a small provincial German village, took a picture of his wife’s hand. If one wants to ask how and why medical technology has come to play such a dominant role in US medicine, the introduction of the X-ray machine makes an especially propitious case study. A significant portion of the rapidly increasing money spent on health care in the United States is spent on imaging technologies, and the tools are used at a much higher rate in the United States than in other industrialized countries ( 3). Not only do such imaging technologies color almost every aspect of patient care, the pictures they produce are usually viewed as trustworthy evidence, determinative findings in instances of clinical ambiguity. We need think only of the quotidian use of the X-ray, the computer assisted tomography scan, the magnetic resonance image, the positron-emission tomography scan, and others. And of the many dramatic innovations we have seen over the past century, perhaps none has had a more ubiquitous impact than the use of imaging technology ( 1, 2). The dominance of scientific thinking and technological intervention are evident in almost every part of health and health care. If one considers what has happened to clinical practice in the United States over the past century, arguably no change has been more consequential than the widespread introduction of science and technology.
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