. The Röntgen rays in medical work . 7, andto dispense with bringing that organ to the surface of the wound. 3. Limited incisions made directly over the calculi through therenal pelvis are to be preferred when practicable. Such wounds ofthe pelvis heal well. 4. Before the operation it is most important to get the urine ina healthy condition. 5. Renal calculi, however small, should be operated on as soon asthey are diagnosed. Their danger to the kidney structure and tothe patients life bears no relation to their size. * British Medical Journal, October 19, 1901, p. 1131. MEDICAL AND SURGICAL AP
. The Röntgen rays in medical work . 7, andto dispense with bringing that organ to the surface of the wound. 3. Limited incisions made directly over the calculi through therenal pelvis are to be preferred when practicable. Such wounds ofthe pelvis heal well. 4. Before the operation it is most important to get the urine ina healthy condition. 5. Renal calculi, however small, should be operated on as soon asthey are diagnosed. Their danger to the kidney structure and tothe patients life bears no relation to their size. * British Medical Journal, October 19, 1901, p. 1131. MEDICAL AND SURGICAL APPLICATIONS 177 With regard to renal calculi, it may be remarked that there is nomethod yet devised of securing a radiographic record in the case ofvery fat patients. Hence, in giving details of cases, it is alwaysimportant to note the girth of the person as well as the lengthof the exposure. Probably no renal calculus could be taken. Fig. 85.—Stone in Kidney. The Stone is shown above(Full Size) ; Plate reduced. in fifteen seconds, except in the case of a very thin subject. AVithmodern apparatus it takes several minutes to get through theabdomen of a stoutly-built man—say 40 inches round the a patient who measured 45 inches round the abdomen, thepresent writer was able to secure a record of ribs and spine. The 12 178 THE RONTGEN RAYS IN MEDICAL WORK likelihood of finding a small calculus is greatly increased by the useof a good form of compression-diaphragm, whereby definition isimproved owing to the cutting of secondary or s-rays, while at thesame time the thickness of tissue to be penetrated by the rays isreduced. Stone in Ureter. Many cases of stone in the ureter have been located by the J. W. Elliott * reported a case in which a calculus was shown inthe right ureter, just above the crest of the ilium, from whichposition it was readily removed by operation. He alluded to sixother cases ment
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