j. j. thomson, wrote a letter to the journal nature in which he detailed his discovery of the presence of radioactivity in well water. soon after, others found that the waters in many of the world's most famous health springs were also radioactive. this radioactivity is due to the presence of radium emanation produced by the radium that is present in the ground through which the waters flow. in 1904, nature published a study on the natural radioactivity of different mineral waters. inspired by this, using preparations of radium salts in bath water was suggested as a way for patients to be treated at home, as the radio-activity in the bathwater was permanent. radium baths became used experimentally to treat arthritis, gout, and neuralgias. röntgenotherapy vs. radium therapy x-ray treatment of tuberculosis in 1910 x-rays and radium were noted by physicians to have different advantages in different cases. the most marked effects produced with radium therapy were with lupus, ulcerous growths, and keloid, particularly because they could be applied more specifically to tissues than with x-rays. radium was generally to be preferred when a localized reaction was desired, while for x-rays when a large area needed to be treated. radium was also believed to be bactericidal, while x-rays were not. because they could not be applied locally, x-rays were also found to have worse cosmetic effects than radium when treating malignancies. in certain cases, a combination of x-ray and radium therapy was suggested. in many skin diseases, the ulcers would be treated with radium and the surrounding areas with x-rays so it would positively affect the lymphatic systems. tuberculosis and iodo-radium therapy after using radium in the surgical treatment of tuberculosis, researchers including béla augustin and a. de szendeffy soon developed a treatment using radioactive methyholated iodine, which was patented under the name dioradin (formed from "iodine and radium") in 1911. application of this treatment was referred to as iodo-radium therapy, and involved injecting dioradin intramuscularly. it seemed promising to the developers, because in several cases, fever and hemoptysis had disappeared. inhalation of iodine alone had been an experimental treatment for tuberculosis in france between 1830 and 1870. commercialization, quackery, and the end of an era (1915–1935) advertisement for a scientifically developed radiation emanation activator. this particular device is suggested for use by augustus callé in a textbook on post-graduate medicine. widespread commercial exploitation of radium only began in 1913, by which time more efficient methods of extracting radium from pitchblende had been discovered and the mining of radium had taken off. commercial products the revigator "radioactive water crock" (1930s) "tho-radia" powder, based on radium and thorium, according to the formula of dr alfred curie the radium commonly used in bath salts, waters, and muds was in low-grade preparations, due to the expense, and their usefulness in curative solutions was questioned, since it had been agreed upon by physicians that radium could only be used successfully in high doses. it was believed that even radiation emanation at higher doses than were useful would cause no harm, because the radioactive deposits were found to have been absorbed and released in urine and waste within a period of three hours. radiation emanation activators radium emanation activators, apparatuses that would apply radium emanation to water, started being produced and marketed. scientifically constructed emanators were sold to hospitals, universities, and independent researchers. certain companies advertised that they would only give them out to others on a medical prescription and would guarantee the strength of radium in each dose. many products which imitated emanation activators were more broadly marketed to the public. one such product was the revigator, a "radioactive water crock." a dispensing jar made of radium-containing ore, the idea was that radon produced by the ore would dissolve in the water overnight. it was advertised: "fill jar every night. drink freely . . . when thirsty and upon arising and retiring, average six or more glasses daily." the american medical association (ama) was concerned that the public was being fleeced by charlatans. in response, the ama established guidelines (in effect from 1916 to 1929) that emanators seeking ama approval had to generate more than 2 μci (74 kbq) of radon per liter of water in a 24-hour period. most devices on the market, including the revigator did not meet that standard. patent medicines many other quack cures and patent medicines were sold on the market. radithor, a solution of radium salts, was claimed by its developer william j. a. bailey to have curative properties. many brands of toothpaste were laced with radium that was claimed to make teeth shine whiter, such as doramad radioactive toothpaste. ostensibly, this would be because the radium would kill the bacteria in a person's mouth. one item, called "degnen's radio-active eye applicator" manufactured by the radium appliance company of los angeles, california, was sold as a treatment for myopia, hypermetropia, and presbyopia. face creams and powders were sold, with names like 'revigorette' and 'tho-radia'. it was also sold as a supplement to smoking cigarettes. companies also marked radioactive pads and compresses for the treatment of illnesses. joachimsthal radium spa hotel in light of the supposed curative properties of radioactivity, a spa was opened up in joachimsthal, the place at which madame curie gathered some of her original samples of radium from spring waters. radon inhalation rooms were set up, where air tubes carried the gas up from a processing tank in the basement; the visitor would then use it through an inhalation apparatus. baths were set up which were also irradiated, and irradiated air was also filtered through a trumpet-like pipe for inhalation. public health concerns concerns about radium were brought up before the united states senate by california senator john d. works as early as 1915. in a floor speech he quoted letters from doctors asking about the efficacy of the products that were marketed. he stressed that radiation had the effect of making many cancers worse, many doctors thought the belief that radium could be used to cure cancers at that stage of the development of therapy was a "delusion" — one doctor quoted cited a failure-to-success rate of 100 to 1 — and the effects of radium water were undemonstrated. around the start of the 1920s, new public health concerns were sparked by the deaths of factory workers at a radioluminescent watch factory. in 1932, a well-known industrialist, eben byers died of radiation poisoning from the use of radithor, a radium water guaranteed by the manufacturer to contain 2 μci of radium. cases sprung up of the development of carcinoma in patients who had used conventional radium therapy up to 40 years after the original treatments. robley d. evans made the first measurements of exhaled radon and radium excretion from a former dial painter in 1933. at mit he gathered dependable body content measurements from 27 dial painters. this information was used in 1941 by the national bureau of standards to establish the tolerance level for radium of 0.1 μci (3.7 kbq). coutard method at the international congress of oncology in paris in 1922, henri coutard, a french radiologist working with the institut curie, presented evidence that laryngeal cancer could be treated without disastrous side-effects. coutard was inspired by the observations of claudius regaud, who found that a single dose of x-rays sufficient enough to produce severe skin damage and tissue destruction in a rabbit, if administered in fractions, over a course of days, would sterilize the rabbit but have no effect on subcutaneous tissues. by 1934, coutard had developed a protracted, fractionated process that remains the basis for current radiation therapy. coutard's dosage and fractionation were designed to create a severe but recoverable acute mucosal reaction. unlike previous physicians, who believed that cancerous cells were more affected by radiation, he assumed that the population of cancerous cells had the same sensitivity for regeneration as normal cells. coutard reported a 23% cure rate in the treatment of head and neck cancer. in 1935, hospitals everywhere began following his treatment plan. radiation therapy today (1935–) main article: radiation therapy "radiation therapy" defined as the utilization of electromagnetic or particle radiation in medical therapy has 3 main branches, including external beam radiation therapy(teletherapy), locoregional ablative therapy (such as brachytherapy (sealed source radiation therapy), selective internal radiotherapy (sirt), radiofrequency ablation, microwave ablation, and optical therapy), and systemic therapy (i.e. radiopharmaceutical therapy, such as radioligand therapy and unsealed source therapy)). there are three branches of radiology dealing with these three therapeutic domains: radiation oncology (teletherapy and brachytherapy), interventional radiology / interventional oncology (selective internal radiation therapy (sirt), locoregional ablative therapy using rf ablation and microwave ablation), and nuclear radiology / nuclear medicine (using radiopharmaceutical therapy (rpt) and systemic unsealed sources). particle therapy is a special case of "radiation therapy" in which "emitted atomic particles" (such as electrons, protons, or neutrons) are used for energy delivery in therapy. particle therapy is heavily used in nuclear radiology / nuclear medicine (radiopharmaceutical therapeutic agents are based on alpha particles, beta particles, or auger electrons), and to some extent in radiation oncology (external electron therapy and recent emerging modalities for external proton therapy). nuclear radiology / nuclear medicine specializes in the internal delivery of particle therapy whereas radiation oncology specializes in the external and locoregional delivery of particle therapy. intraoperative radiation therapy or iort is a special type of radiation therapy that is delivered immediately after surgical removal of cancer. this method has been employed in breast cancer (targeted intra-operative radiation therapy or targit), brain tumors, and rectal cancers. radioactive iodine, which has been used to treat thyroid diseases since 1941, survives today primarily in the treatment of thyrotoxicosis (hyperthyroidism) and some types of thyroid cancer that absorb iodine. treatment involves the important iodine isotope iodine-131 (131i), often simply called "radioiodine" (though technically all radioisotopes of iodine are radioiodines; see isotopes of iodine). notes pusey 1900, p. 302 kassabian 1907, p. 501 coe 1912, p. 302 singer 1914, p. xxv mould 1993 squibb 1900, p. 722 mackee 1921, p. 19 pioneer in x-ray therapy 1957 belot 1905, p. 364 freund 1904, p. 299 belot 1905, p. 812 williams 1902, p. 438 belot 1905, p. 367 belot 1905, p. 88 metzenbaum 1905, p. 22 tousey 1915, p. 1103 grubbe 1902, p. 692 pusey 1900, p. 303 belot 1905, pp. 261–302 kassabian 1907, p. 488 mackee 1921, p. 20 metzenbaum 1905, pp. 26–27 cameron 1912, p. 171 mackee 1921, p. 25 knox 1918, p. 500 knox 1918, p. 499 knox 1918, p. 498 cameron 1912, p. 173 knox 1918, p. 501 strutt 1904, p. 473 tousey 1915, p. 1115 cameron 1912, p. 174 boggs 1919, p. 77 simpson 1917a, 1917b science museum london callé 1922, p. 55 bright 1910, p. 558 moore & kithil 1913, p. 79 moore & kithil 1913, p. 8 moore & kithil 1913, p. 110 frame 1989 radioactive quack cures 1998 works 1915, pp. 107–108 hacker 1987, p. 25. "μci national bureau of standards." chamberlain & young 1937 halperin, perez & brady 2008, p. 4 bomford, kunkler & walter 2003, p. 316 beyzadeoglu, özyigit & ebruli 2010, p. xxiii