Chapters of photomedicine history: diagnostic transillumination technique in 1860-1880s

Abstract

The first devices for diagnostic transillumination of human body tissues and organs used as a light source a platinum wire, which was white heated by current from the battery and protected by the glass screen. Having a small outer diameter, such device could be inserted into the internal body cavity through the natural orifice. In the second half of the 1860s number of structures of this type was proposed and tested. Physicians from Russian Empire became the leading specialists in this engineering and medical area.

In September 1869 the diaphanoscope for obstetric diagnosis, which was developed in Kharkiv by prof. I.P. Lazarevich a year earlier, was successfully demonstrated in Italy. The author has presented diaphanoscope to Santa Maria Nuova Hospital in Florence and Italian physicians reported about diaphanoscope from the rostrum of the II International Medical Congress, held in the same place.

A graduate of Kyiv University, doctor V.A. Milliot, demonstrated similar in design transilluminator in 1867 during the I Congress of Medicine; doctor continued his work in France. Here, in Paris he studied possibilities of electromagnets for the taking out shrapnel and bullets from wounds, but he did give up diaphanoscopy. In 1870 V.A. Milliot published his article in Paris, where he offered some interesting new solutions to improve transillumination diagnostic method – in particular, with regard to the stomach examination. However, in the same year, the Franco-Prussian War began, and soon newspapers published a report about death of the brave doctor on the battlefield while providing with medical care to the wounded French soldiers.

The disadvantage of the proposed designs was a combination of weak light of incadescent filament, which was insufficient to transilluminate through thick layers of tissue, and a large screen heating, limiting the time of intracavitary studies. In the summer of 1870, the St. Petersburg physicist D.A. Lachinov, the teacher of the Forest Institute, published a two-part article, where he described the design of intracavitary transilluminator with a powerful arc light source and the flowing water cooling of screen. Lachinov was the first to use a comparative measurement of the luminous intensity of different sources by Bunsen photometer; and he convincingly demonstrated the advantages of arc source with adjustable carbon electrodes above the incandescent filaments against the luminous intensity. He sought to optimize this promising design for clinical practice, and not for private offices. However, the fact that the electric arc was burning in Lachinov’s construction directly in the cooling water (distillate?), caused reasonable doubts about security of such a system. Perhaps that is why the physicist couldn’t arrange the tests of his transilluminators in animals and humans. One more reason was the fact that in 1871-1872 Lachinov was under investigation due to distribution of anti-government literature among students.

Unable to find practical use in medicine, D.A. Lachinov’s ideas gave impetus to the new developments of domestic physicians. In 1871 doctor K.R. Ovsyany, a graduate of the Kyiv University, built and tested intracavitary transilluminator with an arc light source. Soon, however, a gifted medic left this subject and chose to become an architect.

Atthe III Congress of Russian scientists in Kiev (August 1871) I.P. Lazarevich demonstrated diaphanoscope with flowing water cooling, where the incandescent filament has been replaced by a rigid platinum plate. In this case not the whole internal volume of the screen was cooled, but the annular space between two glass tubes. Lazarevich used this improved device to transilluminate the pelvic organs at congress in Kyiv; later in 1872 he demonstrated the new diaphanoscope to the Society of Russian Physicians in Moscow and presented it at the international exhibitions in London and in Vienna in 1873.