The Fluoroscope Serves as a Warning for New Medical Technology

What does a 100-year-old machine that measured your feet have to do with cutting-edge nanotechnology-based medicine and our genetic code? Everything or nothing, depending on your viewpoint and who is doing the selling.

Almost exactly 100 years ago in 1920, hot on the heels of the discovery of x-rays by German scientist Wilhelm Conrad Röntgen, a new machine was introduced into shoe shops across the globe. Called the Fluoroscope or Pedosscope(UK) the device was essentially a portable x-ray machine with a singular and rather ingenious purpose.

The idea was brilliant. Customers could try on a new pair of shoes and pop their freshly shod feet into the Fluoroscope box. The device would then produce an x-ray image of your feet inside the shoes. People were obviously fascinated by the technology and the novelty aspect of the machine made it an overnight winner. After all, no one wants to buy shoes that don’t fit properly. An estimated 10,000 machines were sold in the US, 3,000 in the UK, 1,500 in Switzerland, and 1,000 in Canada before authorities began discouraging their use.

Today we know the dangers of continued exposure to x-rays. In the 1920’s we didn’t. What we had instead, in the 1920s, was a new breakthrough in technology that we bravely (foolishly) embraced with little or no concern for the wider safety implications of the technology. If history is anything to go by, the lessons we should have learned from the Fluoroscope and numerous other then-emergent technologies which now litter scientific literature, were lost. 

Even after the dangers of the Fluoroscope and exposure to radiation were highlighted, the devices persisted in many shoe shops in the US until the mid-1970s, with many choosing to ignore the health warnings associated with prolonged exposure to x-rays. To this day, shoe companies deny any liability for the introduction of the machines.

In reality though, how dangerous was the Fluoroscope? This breakdown of the radiation provided by the devices, courtesy of Wikipedia, offers some insight.

Large variations in dose were possible depending on the machine design, displacement of the shielding materials, and the time and frequency of use. Radiation surveys showed that American machines delivered an average of 13 roentgen (r) (roughly 0.13 sievert (Sv) of equivalent dose in modern units) to the customer’s feet during a typical 20-second viewing, with one capable of delivering 116 r (~1 Sv) in 20 seconds. British Pedoscopes were about ten times less powerful. A customer might try several shoes in a day, or return several times in a year, and radiation dose effects may be cumulative. 

For perspective, a dose of 300 r can cause growth disturbance in a child, and 600 r can cause erythema in an adult. Hands and feet are fortunately relatively resistant to other forms of radiation damage, such as carcinogenesis, but spare a thought for the operators of these devices who were effectively exposed to massive doses of daily radiation.

What does this have to with my DNA?

Great question and if you haven’t joined the dots yet, allow me. Science has been seriously experimenting with DNA-based medications for well over a decade and in many ways, these medicines are seen as a holy grail by the medical community. With good reason. Many diseases stem from gene combinations gone wrong and our ability to deliver treatment at this level will quite literally revolutionize medicine.

Identifying and isolating faulty genes and our ability to turn on or turn off switches in our genetic coding could mean the end of many diseases we have been previously unable to treat effectively. Most promising in the emergent field of DNA-based medicines is the ability of science to produce treatments specific to an individual. No more hit and miss, but something that’s been built and designed just for you. A treatment that can be deployed within a few days, and that, most importantly, is cost-effective. 

In the above scenario, the patient is the clear beneficiary. Covid accelerated the development and deployment of exactly these types of medicine. mRNA vaccines deliver nano-particle encapsulated genetic instructions directly to our cells. For many patients with co-morbidities and the aged, these vaccines were, and remain, a god-send. 

There is however a need to embrace our newfound mastery of the body’s DNA with extreme and urgent caution. Unlike the Fluorscope that may have caused cancerous lesions in a few feet and rendered a few operators barren, DNA is universal and our current understanding of the technology and its encompassing risks rival that of the early x-ray. We are at the dawn of new technology, and if history has taught us anything, circumspection and caution are called for.

Currently, there are no DNA overlords. There is no national or global oversight of the impacts of these medicines on us, no specific guidelines, or rigorous safety mechanisms to ensure that we are not exposed to the devastating side effects of future treatments gone wrong. 

As of now, we are celebrating our initial medical successes and as I write this, new medications are being prepared or have already been released into the market. Medicines that target our cell structures and DNA and as with the Fluoroscope, we are assured the whole process is completely safe. In fact, why not get your child to try it out? 

I for one, would rather my child were barefoot for a while.