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involving change in density will make the lungs more or less opaque to the X ray. It is of interest, in passing, to discount celexa note that even in health the brightness of the pulmonary area varies. It is lighter in deep in- spiration than during expiration. There must, there- fore, be more blood in the lungs at certain stages of respiration than at others. Further, not all persons have the same pulmonary brightness. It is less in a stout, muscular man than in a thin man. We can learn celexa generic cost to make allowances for these differences in indi- viduals as we do in percussion, and further we usually have an opportunity to compare a healthy with a dis- eased side. In the following four cases, the only ones in which both an X-ray and a post-mortem examination were made at the Boston City Hospital, there was com- plete correspondence between my X-ray examination and the autopsy, which occurred not long after: Case V. — G. H., was a buy celexa young man whose lungs, as seen in the fluoroscope, were normal; the post- mortem gave the same result. It was interesting to note that the heart in death was somewhat higher than in life, and did not extend so far to the right. Case VI. — P. C. , a patient with pneumonia. Both the fluoroscope and the autopsy showed that the whole of the right upper lobe and a portion of the middle lobe were involved. Case VII. — D. F. ; this patient had an old encysted pleurisy extending buy celexa canada vertically along the outer wall of the celexa prices us left chest from the third to the ninth rib. These outlines seen in the fluoroscope, and drawn on the skin, corresponded with what was found at the autopsy. Case VIII. — J. K., a patient with arteriosclerosis; observations and tracings made by means of the fluoroscope showed dark areas to the right of the sternum, and at the post-mortem a calcification in the aorta near the heart was found. 1 The abdomen is a more order celexa without rx difficult field for explora- tion, and nothing is seen as clearly there as in the thorax. The outline of the liver and of the spleen may be followed. I have also seen the outline of the lower portion of the left kidney. Improved apparatus will doubtless enlarge the field of usefulness of this method of examination. Among 1 Since this paper was read a post-mortem has been made of a pa- tient who died twenty-four hours after his order celexa online no prescription admission to the hospi- tal. He was not examined by the X-ray, but the autopsy showed how serviceable this examination would have been in prognosis. The patient was forty years old, had pneumonia of the whole of the upper left lobe, emphysema of the lungs, and a right auricle that was then so distended as to be equal in size to the ventricles. The pneumonia would buy celexa 40 mg have appeared in the fluoroscope as a very dark area, and in contrast with the bright emphysematous right lung, the right auricle would have been most conspicuous. recent improvements is a Crookes' tube in which the platinum is kept cool by a stream of water running through the hollow anode, which makes it practica- ble to use a light of far greater penetrating power than has hitherto been possible. This order celexa is the invention of Dr. William H. Rollins of order celexa online Boston, and is only one among several excellent improvements made by him in the course of his investigation of X-ray tubes. Another is his method of lowering the vacuum after it has become too high by the continued use of the tube. 1 Dr. Rollins has also invented another ap- pliance for surgical purposes. This is an aluminum camera, and consists essentially of an aluminum tube in the interior of which is a photographic film. The metal protects the film from light and moisture and yet order celexa no prescription allows the passage of the rays. Such an instru- ment may be put into any cavity of the body, for in- stance, the rectum, and then an X-ray photograph may be taken of a phosphatic celexa manufacturer discount program calculus in the bladder. In employing X-ray examinations; as in ausculta- tion and percussion, many cases must be studied in order to recognize the conditions presented, and it is obvious that this celexa price comparison method of examination is not so easily carried out as most others. It would be well, however, for the students in all our medical schools to be familiarized celexa cost without insurance with the appearances of the chest as seen in the fluoroscope, while studying ausculta- tion and percussion, for there is much that after hav- ing been demonstrated by both this instrument and the latter method will later be recognized more easily by auscultation and percussion alone. The eye celexa discount card hav- ing assisted the ear to make a more complete picture of certain conditions, the physician is enabled to get a better idea of these conditions in cases in which, for lack of an X-ray apparatus, he must use the ear alone. Further, the X-ray examination will teach him to better appreciate the limitations of aus- cultation and percussion as well as to interpret more correctly the information derived from them. X-ray examinations will be found useful to life-insurance companies. In making buy cheap celexa a diagnosis, physicians will find that although much that the X-ray reveals can be recog- nized by other means it would often be an advantage to have this information confirmed by another method, and we must also appreciate that it can ex- tend our knowledge into order celexa line a field order celexa canada which was previously beyond our reach. A diagnosis may be made by an X-ray examination alone in certain cases, as in aneur- ism, emphysema, and pneumothorax, and in a few generic celexa vs celexa cases by it alone, but as a rule it is only one method and should be used in connection with others. The fluoroscope and stethoscope, for instance, supplement 1 These appliances are made by Kirmayer & Oelling, Bromfield street, Boston, Mass. Digitized by Google

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