. Röntgen ray diagnosis and therapy . thor,revealed the presence of 231 small calculi and one larger stonewhich was arrested in the common duct, thus having prevented thepassage of the smaller sized. The distinctness with which the ribsare reproduced proves that the vacuum of the tube employed wastoo high, wherefore it permeated the calculi which were situateddirectly underneath the focus, while those around it are not sowell penetrated. There is one advantage in the skiagraphy of the contents ofthe gall-bladder over those of the kidney—viz., the possibility ofbringing the plate very near the
. Röntgen ray diagnosis and therapy . thor,revealed the presence of 231 small calculi and one larger stonewhich was arrested in the common duct, thus having prevented thepassage of the smaller sized. The distinctness with which the ribsare reproduced proves that the vacuum of the tube employed wastoo high, wherefore it permeated the calculi which were situateddirectly underneath the focus, while those around it are not sowell penetrated. There is one advantage in the skiagraphy of the contents ofthe gall-bladder over those of the kidney—viz., the possibility ofbringing the plate very near the area to be skiagraphed, the inter-vening tissues being a great deal thinner than in the renal region. Various Types of Biliary Calculi.—The results, of course, areto a great extent dependent on the chemical composition of thebiliary calculi, which is far more complex than that of urinary9 114 THE RONTGEN RAYS concretions. All the different types of calculi (Fig. 71) wereskiagraphed by the author (Fig. 72) (see On the Detection of. Fig. 70.—Concretions in the Hepatic Ducts. Calculi in the Liver and G-all-bladder, New York Medical Journal,January 20, 1900). By this procedure he obtained a visual com-parison of their impermeability. The same calculi were irradiatedthen through the living body, thus practically demonstrating thedifference in translucency (Fig. 73). The common biliary calculi, the most frequent type, are foundto be quite permeable to the rays, and therefore produce only alight shadow. If present in large numbers, the shadow is some-what more conspicuous (Figs. 71, 72, and 73, No. 2). Calculi com-posed of pure cholesterin are less permeable than those of the com-mon type, and show a slightly more distinct shadow (see No. 5). The stratified cholesterin calculi, on account of their admix-ture with calcium, show much less permeability, and therefore pro- ABDOMEN 115 cluce a distinct skiagraph (Nos. 1 and 12). The mixed bilirubincalculi, which contain traces of co
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