Medicine: Ultrasound Surgery

Two men in their late 403 left Iowa City's University Hospital last week and boarded planes to carry them to their homes in the South. Each walked with a fast, short-stepped gait ("festination") and had a marked tremor on his left side. These were symptoms of advanced Parkinsonism, a disorder (cause unknown) of nerve nuclei at the base of the brain. But each man had just been freed of such symptoms on the right side. For the first time, after more than five years of helplessness, each could write legibly and feed himself an in-flight meal. This improvement in a disease bafflingly difficult to treat had been wrought by three "buzzes" (actually inaudible), lasting less than two seconds each, of ultra-high-frequency sound waves.

Ultrasound, as the practitioners of a new and arcane art call it, refers to vibrations above the limit of human hearing (about 20,000 cycles per second*) In industry ultrasound waves are used to precipitate carbon and sulphur from chimney exhausts, abating the smoke nuisance and recapturing useful materials, and for testing big metal components such as locomotive axles for flaws. In dentistry there is the ultrasonic drill. In medicine a few enthusiasts have reported good results with ultrasound in arthritis, neuritis, muscle spasm and athletic injuries. It will break up gallstones or kidney stones in an animal's body, and some physicians hope soon to use it for this in human patients.

Sharper Than a Knife. Nobody knows how ultrasound achieves most of its effects. But its use in neurology at Iowa City has a solid base in years of painstaking research. Physicist William Justin Fry, 39, worked with underwater sound for the Navy during World War II, went to the University of Illinois at Urbana and carried on ultrasound work with funds from the Office of Naval Research. In the early postwar years most ultrasound generators produced only a crude, unfocused beam. Fry built a two-story laboratory with equipment reminiscent of science-fiction illustrations, gradually refined his complex apparatus so that he could focus powerful ultrasound beams from four separate irradiators onto a target about the size of a pinhead.

By this time Fry was ready to join forces with the State University of Iowa's Neurosurgeon Russell Meyers, who had long been convinced that the way to treat Parkinsonism was by destroying nerve bundles in two tiny parts of the brain (one on each side) called the ansa lenticularis. But he found conventional surgery too crude and damaging: it meant putting a knife through healthy tissues to get at the almost inaccessible ansa lenticularis. He saw the same objections to alcohol injections (TIME, March 21, 1955). Dr. Meyers believed that ultrasound might prove sharper and more precise than any scalpel, worked with Fry in designing and building a treatment room for Iowa City.