. 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 . extent during deep inspiration, becauseof the increased density, as already stated ; and second, on account ofpleuritic adhesions. When the patient is convalescing from pneumonia,and the lung has become quite clear, we sometimes find that the excur-sion of the diaphragm has not reached its normal limit. If this limita-tion is not due to the former cause, it may well be due to the presence ofpleuritic adhesions. The following case, with its accompa
. 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 . extent during deep inspiration, becauseof the increased density, as already stated ; and second, on account ofpleuritic adhesions. When the patient is convalescing from pneumonia,and the lung has become quite clear, we sometimes find that the excur-sion of the diaphragm has not reached its normal limit. If this limita-tion is not due to the former cause, it may well be due to the presence ofpleuritic adhesions. The following case, with its accompanying tracings,illustrates this point. PNEUMONIA l«I Tracings were made from the chest of the patient on October 4, 7,10, and 17, 1899, and April 21, 1900. Copies of these are given below,with the exception of that made on October 10. Case I. Simon G., fourteen years old, entered the service of oneof my colleagues at the hospital September 25, 1899, and soon aftercame under my care. Diagnosis : pneumonia. Illness of five days duration. Patient had sharp pain in left chest,with sHght cough, raising nothing. Pneumoma lef/J/c/eOc/d/jer 4^^ jBoa. Fig. III. Simon G. Oct. 4, 1899. Cut of first X-ray tracing. Pneumonic process in left left lung and restricted movement of left diaphragm. X-rays indicated that there had beensome pneumonia on right side also, as shown by shortened excursion of diaphragm ; but it was notdetected by physical signs. (One-third life size.) Physical Examination. — Resonance and respiration good throughoutboth fronts; an occasional sonorous rale; below the level of angle ofleft scapula, dulness, bronchial respiration, whispered and spoken bron-chophony, and subcrepitant rales; tactile fremitus shghtly increased atleft base. Temperature at entrance 103J, pulse no, respirations 40. On the seventh day of the disease temperature fell by crisis tonormal. Shght cough with greenish expectoration. October 4, 1899. X-ray examination zvith screen showed
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