The origins of radiotherapy: discovery of biological effects of X-rays by Freund in 1897, Kienböck's crucial experiments in 1900, and still it is the dose.

Abstract

The discovery of X-rays by Wilhelm Conrad Röntgen (1845-1923) was triggered by pursuing an anomalous phenomenon: arousal of fluorescence at a distance from tubes in which cathode rays were elicited, a phenomenon which suggested the existence of a new kind of ray other than cathode rays. The discovery of biological effects of these X-rays by Leopold Freund (1868-1943) was triggered by pursuit of the purportedly useless phenomenon of epilation and dermatitis ensuing from X-ray-diagnostic experiments that others had reported. The crucial experiments performed by Robert Kienböck (1871-1953) entailed the proof that X-ray-dose, not electric phenomena, was the active agent of biological effects ensuing when illuminating the skin using Röntgen tubes. For both the discovery of X-rays and the discovery of their biological effectiveness, priority did not matter, but understanding the physical and medico-biological significance of phenomena that others had ignored as a nuisance. Present discussions about the clinical relevance of improving the dose distribution including protons and other charged particles resemble those around 1900 to a certain degree.