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lower bimatoprost 0.01 borders; a collection of pus or a growth be- hind the ventricles or a pericardial effusion, for ex- ample, would also alter the appearance of or obliter- ate this area. The whole of the anterior border of the heart, as well as of the posterior border, may also be made out in a few individuals when looking through the body from side to side. ample, bimatoprost price can sometimes be seen purchase bimatoprost in the fluoroscope in this disease. Displacement of the heart when there is pleuritic effusion, especially when the effusion is on the left side and the heart therefore displaced to the right, is readily seen in the fluoroscope, when often it is not demonstrated by means of percussion. In pleurisy of the lumigan bimatoprost left side with effusion, or when the heart is enlarged, the outlines of the right ventricle may be seen much to the right of the sternum. A dilated right auricle, especially in emphysema, may also be distinguished. In one patient during convalescence from pneumonia, the heart was adherent in such a way that the apex was tilted up at each full inspi- bimatoprost canada FlG. 2. Cut showing the heart and diaphragm of normal chest as seen in the fluoroscope during full inspiration, position of heart and diaphragm in expiration. The broken lines show • In a much-dilated heart we can see that its vol- ume is made smaller by deep inspiration, which shows that it is bimatoprost cost capable of being compressed by a forced in- spiration. In a few cases we may thus be assisted to distinguish between a heart bimatoprost uk which is simply dilated and one which is hypertrophied. Enlargement of the heart in arteriosclerosis may be detected, as may also the unnaturally small order bimatoprost heart which obtains in cer- tain conditions. We may also find evidence of bimatoprost 0.03 changes in the arteries in arteriosclerosis. I have taken an X-ray photograph which shows normal ar- teries, and those in arteriosclerosis are, of course, even more easily skiagraphed; the radial arteries, for ex- ration instead of being forced downward. The fluoroscope cannot always be employed to ascertain the size and generic bimatoprost position of the heart, as it re- quires for its use that the neighboring lungs be in a fairly healthy condition, otherwise these organs are less permeable by the rays and do not furnish the contrast with the more solid heart which is necessary in order that it may order bimatoprost online be brought clearly into view. As we shall see later, fluid in the pleural cavity or a dense lung may partly or even wholly obscure some of the cardiac outlines as well as displace the heart. The condition of the lungs may hide that of the heart in so far bimatoprost ophthalmic as it is obtained buy bimatoprost uk bv direct view with Digitized by Google 612 X-RAY IN bimatoprost synthesis MEDICINE. [Medical News the fluoroscope, but on the other hand the condition of the lungs may be an indication of disease of the heart, or of the kidneys. If the circulation of the lungs is such as to cause a passive congestion or edema, it is difficult for the rays to pass through them, and we find the pulmonary areas darker than usual. The practical value of this information may be illustrated by one or two cases. Case I. — A. B., was thought by bimatoprost online his physician to be suffering from emphysema of the lungs conse- quent upon asthma, to which he had been subject for sixteen years. There was much dyspnea. I made an X-ray examination which showed that the lungs were darkened by passive congestion, or edema, and the heart enlarged. Auscultation indicated a mitral lesion. I advised rest, together with digitalis in suitably large doses. This treatment was soon fol- lowed by improvement and the disappearance of the dyspnea. Case II. — C. D., had chronic interstitial nephri- tis, but he was able to be at his business every day. An X-ray examination showed an opacity of the lungs due to edema, which suggested purchase bimatoprost online that the patient was in a more critical condition than had been in- dicated by any other sign or symptom and he was therefore cautioned to put his affairs in order and thus given an opportunity to advantage his family by many thousands of dollars. He suddenly died within two months. In certain cardiac diseases we are now able to fol- low the improvement of cheap bimatoprost the patient not only by the disappearance buy bimatoprost online of the dyspnea, but also by buy cheap bimatoprost watching the lungs in the fluoroscope and observing them gradually grow clearer and clearer, and sometimes, also, by seeing that the enlarged heart has become

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