Roentgen Therapy for Acute Cervical Adenitis

Abstract

The value of the roentgen ray in acute cervical adenitis is questioned by many. Curiously, those least acquainted with the procedure are the ones most doubtful of its efficacy. This situation is probably due to the association of the use of roentgen rays with the treatment of malignant and allied diseases, in which failures are apt to be common, to the paucity of references to this subject in the American literature and, finally, to the innate fear of members of the medical profession of the employment of irradiation in any malady less morbid than a malignant process. It is the purpose of this paper to report results with this form of therapy in acute cervical adenitis, in the hope, thereby, of encouraging other workers to record their experiences. Proper evaluation of this mode of treatment will then be possible.Many practitioners are of the opinion that in the management of a patient with acute cervical adenitis no treatment is as good as any. The frequent failures with the present types of treatment account for this laissez-faire attitude. It is well known (Griffith and Mitchell,1 Boil¬ ing2) that cervical adenitis in childhood frequently terminates in sup¬ puration. In reporting 109 cases of acute adenitis, 96 of which were cervical, Holt and Howland 3 stated that 62 per cent of them ended with abscess. Local applications of heat or cold, or of ointments, have apparently no influence in preventing this outcome, or in shortening the duration of the illness. Ultraviolet therapy has been used with doubtful success. The employment of tonsillectomy, also recommended,4 seems illogical, for by the time a child is subjected to this radical procedure the tonsils and adenoids may no longer be a factor in the etiology. Furthermore, the many instances of acute cervical adenitis in tonsillectomized children are proof that the tonsils and adenoids are not always the offenders. Granted that these tissues are actively infected, such unfavorable conditions are not ideal for surgical treatment.

Historical use of x-rays

“…They emphasized that treatment at higher doses, especially in the 20-50% SED range tended to aggravate the inflammatory response and reduce the occurrence of a successful clinical outcome. 9,58 The clinical success of the x-ray treatment was consistently reported being in the 75-90% range across all investigations over a 16-year period. Table 5 compiles the SED reported in the treatment of cervical lymphadenitis.…”

“…Standard treatments for such massive swollen lymph glands during that era generally included the use of compresses and ointments, neither of which were particularly effective. 9,10…”

“…This result is better than that reported by most authors, probably due to the fact in most of the cases irradiation was performed early.'' (p. 532) Schenck 9 ''The roentgen rays act by shortening the stage of the acute inflammation in the lymph nodes, resulting in rapid resolution of the pathologic process. Whether the rays have a direct bactericidal action is still unsettled.''…”

“…2. After 1922, the number of treatments decreased markedly-four treatments of 50% SED (150 rad per treatment) Rathbone 57 10-20% SED (75-100 rad depending on age, repeated at least twice) Rosenberg 58 10-20% of SED (260 r) Schenck 9 First 21 patients-50% SED; remaining 84 patients-25% SED (125-140 rad)…”

Commentary on Fukushima and Beneficial Effects of Low Radiation

“…The applications include healing of wounds (Calabrese 2013a) and the cure of a wide variety of infections, such as gas gangrene (Calabrese and Dhawan 2012), carbuncles and boils (Calabrese 2013b), sinus infections (Calabrese and Dhawan 2013a), and inner ear infections (Calabrese and Dhawan 2013b). Other applications include the treatment of arthritis and other inflammatory conditions (Calabrese and Calabrese 2013a, 2013b; Rodel et al 2012) and swollen lymph glands (Schenck 1935; Hurwitz and Zuckerman 1937).…”