X-ray treatment for ringworm
01
What institutions accepted
Scalp X-ray irradiation was treated as an acceptably safe mass treatment for childhood ringworm.
02
What the evidence supports now
Scalp irradiation induced hair loss as part of treatment for tinea capitis, together with removal of remaining hair and topical care. It exposes healthy tissue to ionizing radiation, and childhood exposure increases the later risk of brain and nervous-system tumors. Effective antifungal drugs make routine therapeutic irradiation for ringworm unnecessary.
03
Evidence for the overall belief
Open sources, locators and notes
- DocumentsHistorical beliefHealing the children and the nation — The campaign to eradicate ringworm in Israel, 1925–1960Oxford University Press
Where in the source: Chapter 9, "Where is the ringworm?" (December 1949 treatment decision and Drukmann's warning about excessive irradiation); concluding "Summary" (1948–1960 estimate).
Reconstructs the national treatment machinery in detail: Ministry of Health responsibility and funding, Hadassah's organizing and supervisory role, General Sick Fund treatment centers, Shaar HaAliyah and Tel HaShomer facilities, school-related compulsory treatment, and an estimated 26,000–27,000 children irradiated in Israel from 1948 to 1960.
- SupportsPresent correctionTumors of the Brain and Nervous System after Radiotherapy in ChildhoodNew England Journal of Medicine
Where in the source: Abstract, cohort and neural-tumor results; PMID 3173432, available at https://europepmc.org/article/MED/3173432. Full article not inspected.
Long-term cohort study of 10,834 Israeli children irradiated for tinea capitis between 1948 and 1960, documenting increased risk of brain and nervous-system tumors.
- SupportsPresent correctionHealing the children and the nation — The campaign to eradicate ringworm in Israel, 1925–1960Oxford University Press
Where in the source: Chapter 9, "Where is the ringworm?" (irradiation-induced epilation and complementary treatment); "Closure of the camp for treatment of ringworm" and concluding "Summary" (griseofulvin replacement).
Describes irradiation as a means of inducing hair loss within a regimen of hair removal and scalp care, and the subsequent replacement of irradiation by oral griseofulvin.
Institutional episode 01
Israel
Middle East
Israel organized a national campaign in which tens of thousands of children with tinea capitis received scalp X-ray irradiation, then a standard treatment. Hadassah's Drukmann reported skin damage from excessive irradiation in children previously treated abroad. The Ministry of Health funded and regulated the programme, Hadassah supervised its treatment protocol, and a network including the General Sick Fund, Shaar HaAliyah and Tel HaShomer delivered irradiation. By 1952 treatment was compulsory in parts of the public-health programme, including as a condition for infected children returning to school. Irradiation in this programme ended in 1960 as griseofulvin replaced it; long-term Israeli cohort studies later demonstrated increased tumor risk after childhood exposure.
Institutions involved
- Ministry of Health
- Hadassah Medical Organization
- General Sick Fund (Kupat Holim Clalit)
- Shaar HaAliyah Hospital
- Tel HaShomer Hospital
Institutional context
The Ministry of Health made ringworm reportable in February 1950 and funded treatment; Hadassah was given national organizing and professional-supervision responsibility at a December 1949 ministry meeting and issued the treatment protocol; the General Sick Fund, Shaar HaAliyah Hospital, Tel HaShomer Hospital and other authorized centers delivered irradiation and follow-up care. School nurses and local services identified cases and enforced exclusion from school during parts of treatment, but those distributed services are described as implementation machinery rather than listed as one institution.
Why this persisted
Administrative adoptionThe Ministry of Health funded and regulated a national treatment programme, Hadassah supervised the protocol, authorized centers delivered irradiation, and school/public-health services helped identify cases and enforce treatment-related exclusion.
How correction happened
Corrected1960; compensation from 1995
Action: The national programme replaced routine irradiation with griseofulvin; a later law provided compensation for specified radiation injuries.
The national programme stopped routine irradiation in 1960 and shifted to griseofulvin. This establishes withdrawal of the practice, while the account of that change does not establish a contemporaneous risk-based repudiation of the earlier safety judgment. From 1 January 1995, a compensation law provided payments to eligible patients or their survivors for specified illnesses following treatment covered by the law in 1946–1960. The Ministry of Health determines entitlement and the National Insurance Institute makes payments.
Consequences
- Mass irradiation of children
- Treatment required for return to school in parts of the programme
- Increased long-term risk of brain and nervous-system tumors
Evidence for this episode
7 evidence linksOpen sources, locators and notes
- ContextualizesContextHealing the children and the nation — The campaign to eradicate ringworm in Israel, 1925–1960Oxford University Press
Where in the source: Chapter 9, "Ringworm in the State of Israel"; "Treatment with irradiation for ringworm by the GSF"; concluding "Summary", estimate immediately before Table 9.1.
Reconstructs the national treatment machinery in detail: Ministry of Health responsibility and funding, Hadassah's organizing and supervisory role, General Sick Fund treatment centers, Shaar HaAliyah and Tel HaShomer facilities, school-related compulsory treatment, and an estimated 26,000–27,000 children irradiated in Israel from 1948 to 1960.
- DocumentsInstitutional carrierHealing the children and the nation — The campaign to eradicate ringworm in Israel, 1925–1960Oxford University Press
Where in the source: Chapter 9, "Where is the ringworm?" (December 1949 allocation of responsibility); "Establishment of a hospital for trachoma and ringworm in the Shaar HaAliyah immigrant intake camp" (Hadassah supervision and 1953 Tel HaShomer transfer); "Treatment with irradiation for ringworm by the GSF".
Identifies the Ministry of Health and Hadassah as organizers and supervisors, the General Sick Fund's treatment centers, and the hospital network that included Shaar HaAliyah and, from 1953, Tel HaShomer.
- DocumentsMechanismHealing the children and the nation — The campaign to eradicate ringworm in Israel, 1925–1960Oxford University Press
Where in the source: Chapter 9, "Where is the ringworm?" (February 1950 reporting and treatment requirements); Shaar HaAliyah hospital section (Hadassah supervision, treatment protocol and school-exclusion rule); "Treatment with irradiation for ringworm by the GSF" (Ministry arrangements).
Documents statutory reporting and treatment duties, Ministry funding and provider arrangements, Hadassah's supervision of the treatment protocol, and school/public-health implementation. School restrictions varied as follow-up care moved into the community.
- SupportsConsequencesTumors of the Brain and Nervous System after Radiotherapy in ChildhoodNew England Journal of Medicine
Where in the source: Abstract, cohort and neural-tumor results; PMID 3173432, available at https://europepmc.org/article/MED/3173432. Full article not inspected.
Long-term cohort study of 10,834 Israeli children irradiated for tinea capitis between 1948 and 1960, documenting increased risk of brain and nervous-system tumors. The inspected abstract supports the tumor-risk consequence; it does not document school requirements or treatment administration.
- DocumentsConsequencesHealing the children and the nation — The campaign to eradicate ringworm in Israel, 1925–1960Oxford University Press
Where in the source: Chapter 9, Shaar HaAliyah treatment protocol, Remarks (b), and the subsequent paragraph on return to school with a head covering; "Treatment with irradiation for ringworm by the GSF" (February 1950 requirements); concluding "Summary", estimate before Table 9.1.
Documents mass treatment and school-return conditions, supporting the first two consequences. Later community follow-up allowed children to return with a head covering, so exclusion throughout treatment was not uniform.
- DocumentsInstitutional correctionHealing the children and the nation — The campaign to eradicate ringworm in Israel, 1925–1960Oxford University Press
Where in the source: Chapter 9, "Closure of the camp for treatment of ringworm" (government griseofulvin campaign); concluding "Summary" (irradiation given until 1960, when griseofulvin replaced it).
Documents the end of routine irradiation and the government's replacement medication campaign. This establishes a treatment-policy change; it does not establish that recognition of long-term tumor risk motivated the 1960 change.
- DocumentsInstitutional correctionCompensation for Scalp Ringworm VictimsNational Insurance Institute of Israel
Where in the source: Opening eligibility paragraph (effective 1 January 1995; covered treatment in 1946–1960), followed by the Ministry of Health entitlement and National Insurance Institute payment paragraphs.
The official service records compensation from 1 January 1995 for eligible patients or their survivors with specified illnesses following covered irradiation. The Ministry of Health determines entitlement and the National Insurance Institute pays. This documents recognition of defined radiation injuries under statutory conditions, without establishing universal redress or an admission of negligence.
Source registryEach source is registered once and can carry several precise evidence relationships.3 sources
- 017 evidence links
- 02Tumors of the Brain and Nervous System after Radiotherapy in ChildhoodNew England Journal of Medicine2 evidence links
- 03Compensation for Scalp Ringworm VictimsNational Insurance Institute of Israel1 evidence link