Excerpt of the first 3 pages from his notes

Dussik, Mount Sinal, 12/ 10/ 1951

Chairman, ladies and gentlemen,

First of all I want to thank you for the honor to have been invited by you to speak about two problems:

1.The basic idea and the development up to now of a new method, namely, the diagnostic use of ultrasounds in brain-disease and

2. some problems of therapeutic use of ultrasounds as a new way of physical treatment.

I am very glad to have the opportunity of finding contacts with medical circles of New York. I know from my first stay in 1937, at which time I had the opportunity of aiding to introduce Sakel's Insulin shock treatment of schlzofrenia, how useful it is to see the great advances, achieved by medical sclence in this country.

Since my return to Austria in 1937, I was chiefly interested in some problems of neurology, for instance, the use of hypoxemia as diagnostical and therapeutic mean, some investigations connected with those questions, such as the cause and the clinical symptoms or turricefaly, the use of nearly complete transfusion of spinal fluid in acute inflammatory diseases of the central nervous system and the use of ultrasounds.

Since 1945 I was working in Bad Ischl, near Salzburg, Austria where I am the head of a private hospital with a neurological department and a department for intern disease. Research, however, is possible within the limits of my own financial possibilities: it is not supported by any Austrian or other authorities. I beg to consider therefore, that my examinations took place under severe handicaps and therefore could be only of a preliminary nature.

When I worked after my return to Austria in the neurological department of the university Clinic of Vlenna I met the various difficulties in the diagnosis or brain diseases, mainly of brain tumor in an early stage, every day, difficulties which I do not need to outline before you.

I came upon in 1937 the idea of using ultrasounds in the diagnosis by learning, that this form of energy was applied for spotting fish in the ocean. Further, ultrasonic waves were useful for the examination of metals, you know that f.1.now in the United States ultrasounds permit the testing of flaws in aluminium roads to a length of 30 yards, a problem, which can not be solved by X-rays.

And also in neurology: the problem of visualizing a brain tumor f.1.- unless it happens to be calcified-by means of X-ray can not be solved for physical reasons. The difference of attenuation of X-rays due to normal brain tissue and due to a tumor in the brain is not great enough to give a contrast in a plain X-ray picture because the attenuation of X-rays depends on the chemical constitution which does not differ between normal and pathological tissue to a sufficient degree. This difficulty can be overcome by using quite an other energy, the ultrasounds, because the attenuation of this energy depends mainly on the inner viscosity of the medium. And we all know, that a tumor in the brain, but also various other diseases, change very strikingly the viscosity.

Therefore I felt that the various procedures employed in the diagnosis of brain diseases, such as encefalografy or ventriculografy and arterlografy might be supplemented by an ultrasonic method. The injection of air or of a contrast medium in the head is not without inconvenience for the patient and occasionally, involves danger. I may be wrong, but I am feeling up to now, that also electroencefalografy Is not able to solve the whole problem of early and exact diagnosis of brain disease, although this method is very important for the analysis of epileptic cases.

It was my ideas, however to try to obtain pictures of some interior details of the brain, utilizing an ultrasonic transmission method in living human being, to detect the location and-if-possible-the histological nature of brain tumors and also the location and character of other brain diseases.

I must admit, that the practical application of this principle proved to be difficult, much more difficult, than I thought in 1937. At this time medical work in the field of ultrasonic waves was nearly unknown, therefore no date were available regarding the behaviour of ultrasound in human tissue. The question, whether an application of ultrasound in human beings would be harmless, was not yet answered.

Therefore it was necessary to study many problems before I could start to examine living brain. Due to the limited financial possibilities those examinations took long time and were carried out on a relatively small scale. But, I nevertheless, achieved some results.

From the article: Historical Review - THE HISTORY OF ECHOCARDIOGRAPHY by INGE EDLER and KJELL LINDSTROM, Ultrasound in Med. & Biol., Vol. 30, No. 12, pp. 1565 - 1644, 2004

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