. The American journal of roentgenology, radium therapy and nuclear medicine . largelyearly ones, the total number of distinctspontaneous pneumothoraces does notexceed 3 per cent of the patients, of whomfor the past eleven years we have hadroentgenological studies, often six to tenplates of many of the patients. EvenAmberson does not get the percentage ofthe annular shadow cavities which he callspneumothoraces o\er 20 per cent. Barlowand Thompsons further statement thatannular shadow in the pleura is one of Annular Shadows: Are they Ca\ities or Spontaneous Pneumothoraces? 447- the easily recog
. The American journal of roentgenology, radium therapy and nuclear medicine . largelyearly ones, the total number of distinctspontaneous pneumothoraces does notexceed 3 per cent of the patients, of whomfor the past eleven years we have hadroentgenological studies, often six to tenplates of many of the patients. EvenAmberson does not get the percentage ofthe annular shadow cavities which he callspneumothoraces o\er 20 per cent. Barlowand Thompsons further statement thatannular shadow in the pleura is one of Annular Shadows: Are they Ca\ities or Spontaneous Pneumothoraces? 447- the easily recognized indicatin<i signs ofpneumothorax is also wrong, unlesslimited by the words in good x-ray my experience with the oldest cliniciansin the country, these so-called annularshadows are peculiarly likely to give nophysical signs, and, unless of considerablesize, or not drainmg freely, they arevery commonly o\erlooked in phj^sicalexaminations. A brief critical review ot the contentionsof these supporters of the pneumothoraxinterpretation may clear the Fig. 5. Dec. 24, 1921. Annular outline between third andfourth ribs, anteriorly, showing opening intobronchus. No autopsy examinations of their own or ofothers support their contention, and thepathological explanation by Ambersonand Honei) of the origin of these shadowsis against known evidence, and seemsmade to fit a theory. Evans criticizes Dunhams interpreta-tion of some of his stereo-clinic picturesand sweeps the soundness of Dunhamsstudies aside without a single logicalargument or substantiated deduction. Toquote Evans, Dunham failed to showthat this question had been discussed,and, in fact, several cases described asshowing cavity formation were in realitycases of localized air pockets. Evanscontinues: In making a report on a chestexamination last fall, we noted an annularshadow which we described as atypical of a cavity, but no suggestion was made thatit might be a localized was a
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