. 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 . stolic murmur of greatintensity, which is transmitted to back, entirely replaces first sound, andat apex no second sound is heard. The murmur can be heard everywherethroughout the praecordial area and also in neck. At base, secondpulmonic was markedly accentuated. February 11. Thorough and detailed examination by Dr. Arnold atthe out-patient department of the Boston City Hospital. Venous andsubclavian pulse while lying down, disappears on sitting.
. 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 . stolic murmur of greatintensity, which is transmitted to back, entirely replaces first sound, andat apex no second sound is heard. The murmur can be heard everywherethroughout the praecordial area and also in neck. At base, secondpulmonic was markedly accentuated. February 11. Thorough and detailed examination by Dr. Arnold atthe out-patient department of the Boston City Hospital. Venous andsubclavian pulse while lying down, disappears on sitting. Murmur asbefore. I examined this patient with the fluorescent screen on February 11and March 25, 1899, and March i, 1900, and the results of these X-ray 266 THE ROENTGEN RAYS IN MEDICINE AND SURGERY examinations may be seen in the following figures which were madefrom tracings taken from the patients chest on the dates givenabove. In all of these tracings the borders of the heart obtained bythe X-ray examination are. indicated by full lines, and those deter-mined by percussion by dotted lines, except in the third tracing, in Feb 11 ^ 1699 ©. Fig. 159. M. C. First X-ray tracing (one-third life size). Cardiac. The dotted line indicatesthe cardiac outline as determined by percussion; the full line (except of course the median lineand the curve indicating the suprasternal notch) and the broken lines, the outlines of the heart anddiaphragm as obtained by the X-rays. The outer full line on the left indicates the position of theheart in expiration ; the inner, in full inspiration. The distance between the median line and the leftborder of the heart as obtained by the X-ray examination is slightly exaggerated, owing to the mannerin which the outlines are recorded on the tracing cloth. The error is still greater by percussion. which the line obtained by percussion for the left border is the same asthat by the uncorrected X-ray line, and therefore only one line is agreement i
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