History of Medicine

San Francisco’s First Radiographer

      In November of 1895 William Conrad Roentgen first saw the bones of his hand on a fluorescent screen and gave the name “X-rays” to the mysterious radiation that penetrated human flesh. His 

report of the discovery that December “went viral”. Primitive X-ray tubes flooded the market and science magazines instructed do-it-your-selfers (and there were many of them) on how to make their own tubes. By February of 1896, only two months after Roentgen’s publication, an X-ray image was crucial in a gunshot court case in Canada. Meanwhile a San Francisco woman paid close attention to the reports.

X-ray apparatus in Roentgen's lab, Würzburg.  (photo by author)

     Elizabeth Fleischman was born in 1859 in El Dorado County. Her father had arrived from Austria in the Gold Rush, settled in El Dorado, and later moved to San Francisco. Elizabeth entered high

Elizabeth Fleischman

school and was later trained as a bookkeeper. Her brother-in-law, Dr. Michael J.H.Woolf (with whom she lived after her mother’s death)  interested her in the new X-rays. She  took a quick course in electrical science and with borrowed money bought her own X-ray apparatus. She quickly became adept at using it and offered X-ray and fluoroscopy services to the medical community. She is first listed in the San Francisco City Directory (an old version of the Yellow Pages) in 1897 as “radiographer, X-ray laboratory, 611 Sutter”.

From City Directory 1897

     The Spanish-American War and subsequent guerrilla activity in the Philippines after 1898 generated numerous injuries, cared for at the Presidio of San Francisco. Many were brought to Fleischman’s office in order to locate bullets and visualize fractures. Eventually the military purchased their own equipment and Fleischman consulted at the Presidio. She was especially skilled at using

different angles to locate foreign bodies. “We have never failed to go straight to a foreign body embedded in the human anatomy

Bullet in chest, Fleischman image (from Borden, WC, below)

which is shown by her radiographs, while when we have depended on the work of others we have been led into many grave errors”, stated a colonel from the Presidio.[i] One of Elizabeth’s images is shown here, its quality good compared with others from the war. Surgeon General Sternberg, astounded at the work produced by this self-educated woman, commended her in a report. The introduction of X-rays greatly facilitated the treatment of fractures and put an end to probing bullet wounds, saving many a wound from unnecessary infections.

     The American Roentgen Ray Society convened its first meeting in 1900. They were interested in affiliating with the AMA but that would mean excluding non-physicians. But the members were so dependent on non-physicians like Fleischman that they decided to remain independent. Strictly speaking, doctors became “radiologists” while others were “radiographers”.

     Early X-ray images were developed on glass plates coated with silver emulsions, and exposure times were one to twenty minutes depending on body part.[ii] Before long Elizabeth was making dental images and later added cancer treatment to her repertoire. She made radiographs of animals and took others for artistic reasons, submitting some to Camera Craft Magazine. She was a member of the American Roentgen Society and contributed many images to their collection.

     Elizabeth paid a price for her innovative work. The beams from the early X-ray tubes were not well focused, the exposures were long, and she worked up to twelve hours a day with unprotected hands. It was common to place one’s hand in the beam to check exposure quality. By 1903 a dermatitis was irritating her hands, attributed to darkroom chemicals. By 1904 ulcerations appeared, then a carcinoma. She consented to local excision but refused amputation. Next her axillary glands enlarged, and in January 1905 an arm, scapula, and adjacent clavicle were removed as her only hope of recovery. But to no avail, and she succumbed to cancer on August 3, 1905, a victim of her own pioneering work.[iii]

     Elizabeth Fleischman was not the only early user to suffer.

     Clarence Dally was a glassblower who worked for Thomas Edison making light bulbs. Edison created an early fluoroscope and assigned Dally to demonstrate it and similar instruments to customers. He encountered the same dermatitis, ulcers, and local cancers on his hands. He was treated with skin grafts, then amputation of the left hand, four fingers of the right hand, and finally amputation of both arms before he fell victim to metastatic cancer.

     Walter James Dodd was born in London, came to the U.S. at age 10, and worked in Boston. He happened to meet Harvard president Charles Eliot who gave him a job as janitor in the chemistry lab, “the best janitor we ever had” said a professor. He went on to

Walter James Dodd  (www.archives.org)

become the chief pharmacist at MGH. When X-rays were discovered he built his own machine and soon was the “radiology consultant” for the entire hospital. Only then did he go for his MD degree. But his hands had suffered since 1897 - skin grafts and partial finger amputations. When he finally passed away in 1916 of carcinoma he had undergone over 50 operations under ether.

     Briefly mentioned is Frederick Henry Baetjer, a student of Osler and the first radiologist at Johns Hopkins. He submitted to over 100 surgical procedures since the onset of the first dermatitis. There were many others, recognized by Percy Brown as “martyrs to science” in a book.[iv] At least a decade passed before the full dangers of X-rays were appreciated by the larger community.

      Elizabeth Fleischman, San Francisco’s first “radiographer”, while blazing new trails met a tragic end that was all too common.

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[i]  San Francisco Chronicle, June 8, 1900.

[ii] Borden, W C. The Use of Roentgen Rays in the Medical Department of the U S Army in the War with Spain. U.S. Govt Printing Office, 1900.

[iii] Trans. Amer Roentgen Ray Soc. 1908, p155-6.

[iv] Brown, Percy. American Martyrs to Science Through the Roentgen Rays. 1936.

Other sources:

  Kevles, B H. Naked to the Bone: Medical Imaging in the Twentieth Century. 1997.

  Macy, J. Walter James Dodd – A Biographical Sketch. 1918.

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