. Radiography and radio-therapeutics . scent screen is used and the region of the appendix is palpated,the appendix can be seen, and in a number of cases the condition of thestructure may be determined. In this way it is also possible to determinewhether the caecum is bound down by adhesions. It is claimed that by careful technique the appendix can be outlined ineight cases out of ten. It is possible to ascertain accurately the size, shape,and position of the appendix, the presence of kinks, or adhesions to otherstructures. The best times at which to examine the appendix are six to eight hours
. Radiography and radio-therapeutics . scent screen is used and the region of the appendix is palpated,the appendix can be seen, and in a number of cases the condition of thestructure may be determined. In this way it is also possible to determinewhether the caecum is bound down by adhesions. It is claimed that by careful technique the appendix can be outlined ineight cases out of ten. It is possible to ascertain accurately the size, shape,and position of the appendix, the presence of kinks, or adhesions to otherstructures. The best times at which to examine the appendix are six to eight hoursafter ingestion of the opaque food and twenty-four hours after. After sixhours the head of the barium column should be halfway across the transversecolon, the caecum should be well filled, and the appendix outlined. Thepatient should be in the supine position on the table, the screen being on theabdomen. The region of the appendix is gently massaged with the protectedhand, or, better, by the use of a large wooden spoon. The caecum and. THE LARGE INTESTINE 363 colon are displaced upwards ; when food enters readily the whole of theappendix should show. If the lumen is in places contracted the narrowingwill show. When the structure is occluded near its base then the food doesnot enter at all. All cases should be carefully scrutinised to determine if possible thecondition of the appendix. Many obscure abdominal conditions may betraced in this way to the appendix, which will probably be found to be in astate of chronic inflammation. Examination of the Large Intestine The large intestine is divided into (1) caecum ; (2) ascending colon ; (3)hepatic flexure ; (4) transverse colon ; (5) splenic flexure ; (6) descendingcolon; (7) sigmoid flexure (pelvic colon); (8) rectum. The anatomicalrelations of these parts should be clearly understood. The caecum is that portion of the colon which lies below the ileo-csecalvalve. It is almostentirely surroundedby peritoneum, and,being freely mov-ab
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