The Röntgen rays in medical work (1899) (14570268770)

Identifier: rntgenraysinmedi00wals (find matches)

Title: The Röntgen rays in medical work

Year: 1899 (1890s)

Authors: Walsh, David

Subjects: X-rays Radiography X-Rays Radiography

Publisher: London : Baillière, Tindall and Cox

Contributing Library: Francis A. Countway Library of Medicine

Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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eft upper thorax, where, owing to thelarge and emphysematous lungs, it could not be diagnosed byordinary physical signs. Indeed, an experienced physician sub-sequently denied in court that an aneurism existed. A dilated aorta can be seen from the back on the left side of thevertebral column. Bouchard says that when aortic insufficiencyis present, pulsating aortic shadows are visible on both sides ofthe spine—that is, in the ascending and the descending portionsof the aorta. Hypertrophies of the heart are readily examined on the MEDICAL AND SURGICAL APPLICATIONS 189 screen. In those of the left ventricle the apex elongates, and theclear space usually seen between the heart and liver on deepinspiration is either diminished or disappears altogether. The screen phenomena of right-sided hypertrophy are thusdescribed by Kegnier: In hypertrophy of the right ventricle,the heart, drawn down at the base, tends towards a horizontalposition. When the right ventricle undergoes excessive enlarge-

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Fig. 92.—Aneurism of Aorta in which Physical Signs were absent.(Diagnosis, aphonia from recurrent laryngeal neurosis. Large fusiform aneurisminvolving entire arch of aorta. J. M. Scott, M.D., American X-ray Journal, July, 1898.) ment, there may be twisting around the longitudinal axis of theheart, and the right ventricle is pulled to the front. One recog-nises that fact on the screen because the shadow of the rightheart becomes more distinct when the patient is examined fromthe back than from the front. There may also be a twisting ofthe heart around the vertical axis of the body, the base beingdirected backwards and the apex to the front. This twisting is 190 THE RONTGEN RAYS IN MEDICAL WORK visible when one examines the patient from the left side: thecardiac cone is then sharply shown in its whole length. In com-pensatory hypertrophies of the heart from sclerosed arteries orrenal cases, the auricles can be seen beating to the left of thesternum.* Dr. Eegnier mentions a case which

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1899

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