Antoine Béclère: radiology before electricity

Antoine Béclère (1856-1939) gave his name to an AP-HP hospital in Clamart, near Paris.^1,2,3 By 1908, his peers already saw him as the father of French radiology.⁴ The son of a Paris doctor, he passed the competitive examination for Paris hospital physicians in 1893 and made his name in pediatrics.^1,5

In 1896, at the office of Paul Oudin, a friend from his years as an intern, he attended a fluoroscopy demonstration.⁵ A servant stood behind the screen, and Béclère watched her heart beat.⁵ At the apex of one lung, an opacity caught his eye; the woman, he learned, had a history of hemoptysis.⁵ He would later describe this path as "the way to the Promised Land."⁵

From January 1, 1897, Béclère ran the general medicine department of Tenon, a hospital in Paris.^5,6 Röntgen had announced his discovery of X-rays a year earlier.¹ The administration would not pay, so Béclère bought the equipment himself.⁶ That left the power supply, as he later wrote to his former student Iser Solomon: "How was I to manage, in this hospital without any electricity?"⁶

His answer was an electrostatic machine built by Drault: four 45 cm plates turned by a hand crank.⁶ It delivered no more than two tenths of a milliampere, too little for a radiograph.⁶ So Béclère kept to fluoroscopy, and even that meant a long wait in the dark until the eyes adjusted.⁶ Then accumulators took over, and they had to be sent into town for recharging.⁶

Day to day, Béclère examined his patients by fluoroscopy and traced anything abnormal onto transparent paper laid against the screen.⁶ Tuberculosis was a particular concern: he devoted a book to it in 1899.⁷

Radiographs on glass plates were rare.^6,8 On June 11, 1897, Béclère showed the Société médicale des hôpitaux de Paris a case of pyopneumothorax on a plate that had taken a 30-minute exposure.⁶ Nor could the hospital develop the plates: his wife Cécile did it at home, in a room fitted out as a darkroom.^6,8 The radiology historian Guy Pallardy calls her "the first radiographer."⁸

Béclère held that "to know a subject well, you have to teach it."⁹ He gave his first lessons at Tenon in 1897, which the French Society of Radiology regards as the first teaching of radiology.^4,8 A weekly course opened on Sunday, November 6, 1898.⁸ For the practical sessions, the Assistance Publique, which ran the Paris hospitals, set three conditions: Béclère paid the costs, students stayed out of the wards, and they practiced on one another, never on a patient.⁸

His young cousin Henri Béclère, one of his students, remembered classes in a former chapel whose roof leaked so badly that at times you had "to bring umbrellas."⁸ Some colleagues mocked his "bubbles and playthings."⁹ He went on to train hundreds of doctors, from France and abroad.⁹

Late in 1898, Béclère took over a department at Saint-Antoine Hospital, which was no more connected to the grid than Tenon.^6,8 A small plant on site did produce direct current, but for one purpose only: heating the incubators of the maternity ward.⁶ He was allowed to divert some of it to his examination room.⁶ The maternity ward needed it mostly at night; radiology, for fifteen to thirty minutes in the morning.⁸

In 1904, Béclère published a paper on shielding doctors and patients from the harmful effects of the new radiation, in which he recommended protective gloves and goggles.¹⁰ The rays left their mark on him too: he later had to have the last two fingers of his left hand amputated.⁹

In December 1908, Béclère gathered fellow radiologists at his home on rue La Boétie.⁴ On December 17, they formed the board of the Société de radiologie médicale de Paris, with Béclère as president.⁴ He liked to say: "No one can become a good radiologist without first being a good clinician."⁴ In 1913 the society took the name Société de radiologie médicale de France; today it is the French Society of Radiology (SFR).⁴