No quacks or fakes need apply.

The one certainty in medicine is that the introduction of a new technobogy begets a new scientific organization and a new journal. Radiology is no exception, for it was only a matter of months after Roentgen’s announcement that the American X-Ray Journal was published in 1897. This project, the first regularly published radiology journal in America, was the brainchild of Heber Robarts of St. Louis, and was a precursor to the AJR. Dr. Robarts, who published, edited, and financed the journal, referred to it as “the parentjournal ofthe world” [1 , 2]. In 1900, shortly after the journal appeared, Dr. Johan RudisJacinski of Cedar Rapids, IA, circularized about 40 physicians, including Robarts, regarding the formation of a society of workers in the new field. Representatives of the American Medical Association responded with a suggestion that such a society be a small subsection of the larger organization, but the neoradiologists believed that the new society should encompass physicists and even manufacturers, none of whom was eligible for full AMA membership. Consequently, a meeting was held in the office of Dr. Robarts in St. Louis, and the Roentgen Ray Society of the United States was established, with the first annual meeting called for December 1415, 1900, at the Grand Central Palace in New York. No formal mmutes of the first two meetings (New York City and Buffalo) exist, but by the third meeting, held in Chicago, the new society boasted 221 members and a new name. To encourage the affiliation of Canadians, the organization now had the grander title of the American Roentgen Ray Society (ARRS). However, there was still no clear description of what the qualifications for membership should be [3]. We recall that the introduction of the roentgen ray had started a ground swell of sensational claims and unregulated use by anyone with access to an electrostatic machine [2]. In 1891 , a group of physicians who used electrical stimuli to treat paralysis and muscle weakness formed the American Electro-Therapeutic Association. General interest in their techniques was sufficient for the University of Michigan to include electrotherapeutics as a required course for all medical students. As with most new methodologies, some enthusiasts had extended their field of activity to include treatment of other problems, probably less suited to this technique, such as uterine fibroids and sexual impotence [4]. These ebectrotherapists had one thing in common: they all had electrostatic units in their offices. These units were ideally suited for adaptation to the production of X-ray images. At the sixth annual meeting of the American Electro-Therapeutic Association in September 1896 (10 months after Roentgen’s announcement), papers on the physics of X-nays were given and members were invited to the General Electric plant in Lynn, MA, to observe and learn the new method of X-ray production [1]. Although the call to the first meeting of the ARRS specified “no quacks or fakes of what ever sort need apply,” the open invitation to those “without credentials if they are members of medical or other scientific societies” resulted in the enrollment of manufacturers, salesmen, and other such nonphysicians. The electrotherapists joined in great numbers and were soon a dominant factor in the activities of the organization. Dr. Robarts offered the American XRay Journalto the society as its official journal, but his free-wheeling advertising policy, which allowed ads not only for suspect schools of electrotherapeutics but also for oil and mining stocks and various patent medicines, created doubts about the publication’s scientific validity. In 1902, a disheartened Robarts sold the journal to a controversial electrotherapist, Harry Preston Pratt, who also was the owner of the Chicago College of X-Ray and Electro-Therapeutics. Dr. Pratt worked energetically but unsuccessfully to have the Chicago Electro-Medical Society designated as the official branch of the ARRS in the central United States. Under his control, the Amencan X-Ray Journal was equally unsuccessful and soon expired. The turmoil created by the varying qualifications and consequently varying goals of the membership was interfering with the hopes of the ARRS to achieve scientific respectability and at the same time to elevate radiology to the level of a recognized specialty. Dr. Preston Hickey told the society, “Unfortunately the mere possession of electrical instruments has often served as a cloak for quackery.” “These members,” he continued, “include the dangerous and unscrupulous man with the cloak of alleged medical learning who fearlessly advances diagnoses on boldly promises cures which can only exist in his imagination.” In the technology-driven age in which we live it would appear that little has changed. Dr. Hickey strongly urged the society to place “the stamp of disapproval in no uncertain way on such pretenders” [5]. At the Louisville meeting of the ARRS in 1905, the Executive Committee reasserted its control and dropped 78 members, 16 of whom were nonphysicians. Indeed, 35 of those expelled had been charter members. This drastic move resulted in the loss of almost one third of the membership of the ARRS, but it was considered essential to guarantee the continued growth of the specialty. The connection with electrotherapeutics was now broken forever. What was useful in electrotherapy became part of physical medicine; the extremist positions that could not stand the test of experience eventually disappeared [1]. The ARRS now had its own scientific journal and control over its membership requirements and its destiny. Then, as now, “no quacks or fakes need apply” [6].