. The Roentgen rays in medicine and surgery as an aid in diagnosis and as a therapeutic agent : designed for the use of practitioners and students . Fig. 140. Mary F. May 12. Second X-ray examination with screen. Less effusion in leftchest. Darkened left apex from tuberculosis. Light area seen between the effusion and darkenedapex. Excursion of diaphragm on right side 7 centimetres greater than at first examination. (Cutone-third life size.) May 18. Thiid X-Ray Examination with Screen.—^The light areanoted on May 12 had become so broad that a part of the left border of theheart could t This in


. The Roentgen rays in medicine and surgery as an aid in diagnosis and as a therapeutic agent : designed for the use of practitioners and students . Fig. 140. Mary F. May 12. Second X-ray examination with screen. Less effusion in leftchest. Darkened left apex from tuberculosis. Light area seen between the effusion and darkenedapex. Excursion of diaphragm on right side 7 centimetres greater than at first examination. (Cutone-third life size.) May 18. Thiid X-Ray Examination with Screen.—^The light areanoted on May 12 had become so broad that a part of the left border of theheart could t This increase in the Hght area showed a further subsidence of ■. The darkened apex still persisted (Fig. 141). PLEURISY WITH EFPUSION. EMPYEMA 225 The next case, John J. L., illustrates the appearances seen on thescreen when the patient is suffering from pleurisy with effusion onthe rio;ht side and tuberculosis at the left apex : —• Name IdtOAA^ f^ Age / f Date TlO^/o I Ocrdpation Vol. Pciz^ AddressDiagnosis. Fig. 141. Mary F. May 18. Third X-ray examination with screen. Still less fluid in left area between tuberculous left apex and fluid is larger. A portion of the left border of the heartcan now be seen. Excursion of diaphragm on right side centimetres. (Cut one-third life size.) Case II. John J. L., thirty-four years old, entered my service atthe hospital May lo, 1899. Diagnosis: pleurisy with effusion. Family History. — Mother died of Brights disease, and her threebrothers of tuberculosis. Q 2 26 THE ROENTGEN RAYS IN MEDICINE AND SURGERY Personal History. — Excessively alcoholic; frequent attacks ofvomiting. Present Illness. — For some weeks, pain in epigastrium and muchvomiting ; slight dry cough for two months; some loss of weight butno night sweats; chilly sensations a week previous to entrance; nodyspnoea ; anorexia ; bowels loose.


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