Interstate medical journal (1917) (14760704766)

Identifier: interstatemedica2419unse (find matches)

Title: Interstate medical journal

Year: 1917 (1910s)

Authors:

Subjects: Medicine

Publisher: St. Louis, : Interstate Medical Journal

Contributing Library: The College of Physicians of Philadelphia Historical Medical Library

Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

Text Appearing Before Image:

distal part of the small bowel and even fillingthe rectum (Fig. 3). The colon contained large quantities of mucus.The appendix lumen was visible, very painful on pressure, on dis-placement, and on traction, lay behind the ascending colon, and was INTERSTATE MEDICAL JOURNAL 51 brought to view by displacing the latter. These findings justified,together with the clinical findings, the assumption of appendicularinvolvement, which was verified at operation, the appendix beingremoved as diseased. On the roentgen ray plates nothing char-acterizing the lesion of the appendix as tuberculous was seen. Butthe spacing of the bowel at the ileocecal junction in the roentgenplates, so characteristic of tuberculosis, was completely overlooked,and the distribution of the intestinal contents over the whole intes-tinal canal, with evidence of mucus, showed plainly the presenceof diarrhea, but its significance as a sign of tuberculosis was notappreciated at the time—December, 1914 (Fig. 4). The excised

Text Appearing After Image:

Pig. 3. bowel of the first specimen at a second operation shows the out-ward appearance of the terminal ileum and cecum. Compare thiswith the roentgen plate of the hardened specimen (Fig. 5) andthe photograph of the opened gut (Fig. 6). In the latter we seesmall and very large ulcers, the latter separated by ridges whichnearly completely obliterate the lumen of the bowel. After the extirpation of the ileocecum, we neglected to fillthe fresh excised lumen with hot barium wax; otherwise we couldhave compared this with the original plates. The formalin hard-ened specimen was, however, exposed to x-rays, and one may notethe lumen as it appears filled with air and compare it with theexternal and internal appearance of the bowel and with the roentgenray appearance of the living bowel. We see not only the narrow- 52 INTERSTATE MEDICAL JOURNAL

interstate medical journal 1917 book illustrations medicine x ray roentgen rays medical devices healthcare medical illustrations tuberculosis infectious diseases images from internet archive

1917

The College of Physicians of Philadelphia and the National Endowment for the Humanities

http://commons.wikimedia.org/

public domain