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Google THE MEDICAL NEWS A WEEKLY JOURNAL OF MEDICAL SCIENCE. Vol. LXXII. New York, Saturday, May 14, 1898, No. 20. ORIGINAL ARTICLES. X-RMf IN MEDICINE. 1 By FRANCIS H. WILLIAMS, M.D., OP BOSTON. . The X-rays as a means of studying anatomy, physiology, and buy benoquin pathology in the living body have many sides, but we, as practitioners, are chiefly con- cerned with what may directly promote the welfare benoquin price of our patients. From our point of view, then, this new means may be considered simply as a method of examination, and it is my privilege to-day to briefly indicate to you some of the ways in which it may be of service to physicians, in contradistinc- tion to surgeons. It is chiefly adapted to certain lines of study, and its limitations are drawn by pathologic conditions which involve a change in shape, as in cardiac enlargement; in chemic compo- sition, as in rickets and calculi; or in density, as in pneumonia. I shall limit myself to a few words in regard to the method of making examinations and then take up, by way of illustration, some of the diseases in which they most readily find their appli- cation. The apparatus required in making medical X-ray examinations is as yet expensive and difficult to manage. It should be of the best, and furnish a steady light, neither too strong nor too weak, and of a quality to differentiate well between different tis- sues, that is, adipose tissue, benoquin cream 20 muscles, and tendons. It is important to be able to vary the intensity benoquin cream of the light while looking in the fluoroscope.* The examination may be conducted with the patient in any position. Hospital patients who are too ill to sit or stand may be placed upon a stretcher and carried to the X-ray room. The stretcher may then be placed upon suitable supports and an exam- ination made without disturbing the patient. In private practice, if the patient is too ill to come to my office, I benoquin 20 send a portable X-ray apparatus to the house. The room should be darkened and the phy- 1 Read by invitation at the Ninety-Second Annual Meeting of the New York State Medical Society, January 25, 1898. * This may be done with the static machine, by varying the length of the spark-gap or the speed of the machine; with the coil, by varying the spark-gap, changing the speed of the commutator, or using more or less condenser. I some time ago devised ad- justments for benoquin monobenzone cream thus varying the intensity of the light and have found them a necessary part of the apparatus. I have also arranged a brush for the commutator of the coil so that it now requires litUe or no attention . The static machine and the coil were devised by vi essrs. C. L. Norton and R. R. Lawrence of the Massachusetts Institute of Technology and they are made by E. S. Ritchie & Sons, Brookline, Mass. sician be careful to wait fivt or ten minutes in the dark room, buy benoquin cream or else wear dark smoked glasses a few minutes (if in the daytime) before making the ex- amination, in order that his retinae may be in a con- dition to benoquin cream for sale use the fluoroscope. The tube should be placed below the stretcher, under the mid-sternum, on a level with the fourth rib and two feet or more from the patient; it should be brought to its exact position by plumb lines. buy benoquin online The benoquin online outlines, as seen in the fluoroscope, may be recorded by first dotting and then drawing them on the skin with monobenzone benoquin a crayon 1 opaque to the rays, but the physician must bear in mind that the skin may be moved either by the crayon or by the movements in respiration or by changes in the position of the patient. These lines may be traced on tracing- cloth, or they may be measured off and benoquin vitiligo transferred to a chart. Among the scores of thousands of examinations which have already been made with this new agent by persons necessarily inexperienced it is not sur- prising that in some instances harmful effects have followed; but the number of such effects is so small, when all the circumstances are taken into considera- tion, as to prove that with the better knowledge furnished by experience, the rays are practically harmless. Untoward results from X-ray examina- tions are, I believe, unnecessary, and entirely avoid- able. I have never seen any inconvenience follow their use in the more than one thousand examina- tions that I have made. Among the many ways in which the X-rays assist us is that demonstrated by Dr. Fisk of New York, who has shown how gouty deposits may be recog- nized by an X-ray skiagraph; he has also pointed out that a differential diagnosis may be made between a gouty and a rheumatic process. Examination of the Heart in Health. — The best view of this organ is obtained during full inspiration, as then the diaphragm is so depressed as to allow the apex to be seen; in some persons the heart is de- pressed during full inspiration about one inch and pushed toward the right so that the right ventricle may in some cases be indicated on the right side of the sternum. In expiration, the outlines of the heart are not so complete, as the diaphragm is then higher. The apex beat, as felt, does not always

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