American quarterly of roentgenology (1909) (14734387326)

post operative roentgen irradiation following the radical operation for carcinoma of the uterus

Identifier: americanquarterl02amer (find matches)

Title: American quarterly of roentgenology

Year: 1909 (1900s)

Authors: American Roentgen Ray Society

Subjects: Nuclear Medicine Radiography Radiology Radiology

Publisher: Pittsburgh : American Roentgen Ray Society

Contributing Library: Francis A. Countway Library of Medicine

Digitizing Sponsor: Open Knowledge Commons and the National Endowment for the Humanities

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a hole in the center of a sheetof protecting material 18 inches square which was fastened bytapes passed around the patients body. The tube could thenbe placed in contact with the bell mouth of the speculum whichserved to center the tube to it. The coil terminals, preferablycarried from overhead, were easily adjusted and out of theway. This method had one draw-back—the difficulty of ad-justing the speculum at angles to reach as much of the parime-trium as possible. This was overcome in later cases by using 44 American Quarterly of Roentgenology a special tube shield to which a speculum could be attached sofirmly that it could be adjusted to quite an angle from thenormal direction of the vagina. A small plug of cotton in thespeculum prevented any secretion from reaching the Roentgentube. This shield was so arranged that a leather filter suchas used by Pfahler could be inserted between tube and specu-lum. The knee chest position, at first difficult to maintain, soonbecomes endurable.

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If treatment is begun soon after operation the patient is bestplaced on her back with the knees elevated and the legs sup-ported iby a strap or rest. An ordinary office chair can be usedand the head lowered as much as possible in an exaggeratedlithotomy position. The tube and shield are supported in anordinary tube stand, with the axis of the tube in a horizontalplane. This brings it well out of the way of the feet of thepatient. jj If1^ By observing proper antiseptic measures treatment can bebegun in this position on the second day and continued dailywhile the patient is in the hospital. The lead glass speculi are Dachtler: Carcinoma of the Uterus 45 easily sterilized and are connected to the tube shield after in-sertion and the danger of infection eliminated. In the early treatment it seems advisable to use speculi ofdifferent lengths and give both deep and superficial irradia-tions. This is especially indicated in advanced cases of carci-noma of the cervix and may help to prevent r

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1909

Francis A. Countway Library of Medicine

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