Mihran Kassabian

Mihran Krikor Kassabian (August 25, 1870 – July 14, 1910) was an Armenian-American radiologist and one of the early investigators into the medical uses of X-rays. His contributions to radiology included the introduction of a positioning device that accurately displayed the round nature of the ribs on an X-ray image. He served as vice president of the American Roentgen Ray Society (ARRS). He died of skin cancer related to his repeated exposure to high doses of radiation.

Mihran Krikor Kassabian was born in Kayseri in the Cappadocia region of Asia Minor. He attended the American Missionary Institute there. He went to London to study theology and medicine with the initial goal of becoming a missionary. In London, he also developed a personal interest in photography. He moved to the United States and entered the Medico-Chirurgical College of Philadelphia. After taking a hiatus from his studies to serve in the Spanish–American War, Kassabian returned to Philadelphia and completed medical school.

After graduating from medical school, Kassabian worked as an instructor at the Medico-Chirurgical College. In 1902, he resigned from that position and took over as director of the Roentgen Ray Laboratory at Philadelphia General Hospital. Under Kassabian's predecessor, George E. Pfahler, the two-year-old X-ray laboratory at Philadelphia General had recently made the second-ever X-ray diagnosis of a brain tumor. Combining his interests in electrotherapy, photography and the use of X-rays, Kassabian was able to establish radiology as a clinical entity worthy of its own department.He served as a delegate of the American Medical Association at international conferences, and he was a vice president of the American Roentgen Ray Society (ARRS).

Kassabian invented a positioning device for chest X-rays that showed the body's rotundity; previously, X-ray images had rendered the ribs as flat. He wrote a textbook, Electro-therapeutics and Roentgen Rays, which was widely employed in American medical schools. Kassabian studied the feasibility of imaging infants' hearts with X-rays and a contrast agent, bismuth subnitrate. He reported on this work in 1907, but due to the difficulty of controlling contrast agents and the rapid beating of the heart, his procedure did not become a standard medical practice.

As an expert witness in court, Kassabian worked to establish the value of X-rays in the American legal system. He was chair of the medicolegal committee of the ARRS, and he believed that X-rays could help to elucidate medical findings for judges and juries. He hoped that the incidence of frivolous lawsuits could be decreased if X-rays were used to objectively characterize the nature of a potential plaintiff's injuries.

In 1907, Kassabian served on the search committee that appointed the first pastor of the Armenian Martyrs' Congregational Church. The next year, he married Virginia Giragosian from Constantinople. He had three brothers; they were jewelers in Smyrna.

Kassabian's clinical work included the acquisition of fluoroscopic images. This work predated the routine use of X-ray plates to take static images, and it required Kassabian to be routinely exposed to high doses of radiation. The doctor first noted reddened areas of skin on his hands in 1900. At first he felt that the issue might be related to the use of metol in developing X-rays, but he realized that the problem persisted even when he handled metol with rubber gloves.

Kassabian's first published paper dealt with the irritant effects of X-rays. In that paper, he mentioned the evolution of the issues with his hands. Though Kassabian realized that the X-ray exposure had caused the problem, he argued against the use of the word burns to describe radiation injuries because he thought that this wording might alarm the public and stall the progress that was being made in radiology.

In 1902, Kassabian sustained a serious radiation burn to his hand. Six years later, necrosis had set in and two of the fingers on his left hand were amputated. Kassabian kept a journal and took photographs of his hands as his tissue injuries progressed.

Kassabian was later diagnosed with skin cancer related to the radiation injuries. He continued to work with vigor during his illness; he did not want his patients to know that he had been made ill by radiation exposure. The cancer spread up Kassabian's arm. Kassabian's physicians, who included Philadelphia surgeon William Williams Keen, performed surgery.

In the spring of 1910, Kassabian had another cancer-related surgery, this time to remove muscle from his chest. On July 12, 1910, The New York Times reported that the physician was seriously ill and hospitalized at Jefferson Hospital. He died two days later. Shortly before Kassabian's death, the J. B. Lippincott Company announced that it would publish a second edition of his textbook.