. Röntgen rays and electro-therapeutics : with chapters on radium and phototherapy . ion: The restricted diaphragmatic movementsmust be regarded as very suspicious of phthisis. This sign, first referredto by Williams, of Boston, has had no theory advanced to explain itsexistence. I will briefly summarize my investigations which gave birthto the theory that an emphysematous condition of the lungs exists inphthisis. Eokitansky and Brehmer noted that lungs too voluminouscoupled with a small heart characterized the phthisical habitus. If thephysician were to depend on percussion dulness as an evid
. Röntgen rays and electro-therapeutics : with chapters on radium and phototherapy . ion: The restricted diaphragmatic movementsmust be regarded as very suspicious of phthisis. This sign, first referredto by Williams, of Boston, has had no theory advanced to explain itsexistence. I will briefly summarize my investigations which gave birthto the theory that an emphysematous condition of the lungs exists inphthisis. Eokitansky and Brehmer noted that lungs too voluminouscoupled with a small heart characterized the phthisical habitus. If thephysician were to depend on percussion dulness as an evidence of earlyphthisis, the affection would never be recognized; lung resonance, notdulness, is the early physical sign of phthisis. The rays are invaluablein the recognition of emphysema ; in this condition, the lungs seem toolarge for the chest, the diaphragm is low and its excursions restricted. Diseases of the Diaphragm. — In spasm^ says Abrams, dia-phragmatic movements are practically suspended on the affected side. ^Journal of the American Medical Association, May 3, Fig. 176A.—Lungs (dorsal decubitus). Patient lies on a Kin. x 17in. (35 x 42 cm.) plate, with thearms extended over the head : the anode at a distance of in. (62 cm.) in the median line, correspond-ing- to the junction of the third and fourth front ribs. This position may be employed in radiographingthe arch and descending aorta. For radiographing the heart, the tube must be displaced downwardto the fifth interspace. APPLICATION OF THE X-EAYS. 305 Suddenly the diapliragm contracts and descends several inches below itsnormal descent. Singultus may accompany the descent, whilst cyanosisand dyspnoea become intense. In paralysis, movements of diaphragmon the affected side are suspended ; during inspiration, the midriff diaphragmatic pleurisy, movements of the diaphragm are very muchrestricted or even suspended. The upper part of the lung is brighterthan normal, owing to over-distention. ^
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