. 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 . four weeks. He had had chills which obliged him toremain in bed for nine days ; cough, dull pains in the right chest, slightdyspnoea. Physical Examination. — Lungs : right lung does not move as much atextreme end of inspiration as does left; slight dulness throughout rightback and in front above third rib; slight increase in tactile fremitus ;increased whispered and spoken voice ; no rales heard. Heart: rightborder centimetres to right of media
. 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 . four weeks. He had had chills which obliged him toremain in bed for nine days ; cough, dull pains in the right chest, slightdyspnoea. Physical Examination. — Lungs : right lung does not move as much atextreme end of inspiration as does left; slight dulness throughout rightback and in front above third rib; slight increase in tactile fremitus ;increased whispered and spoken voice ; no rales heard. Heart: rightborder centimetres to right of median line, left border centime-tres to left of median line. Pulse : of good volume and tension ; slightthickening of the radial arteries. January 17. X-Ray Examination xvitJi Screen. — Lungs brighter thannormal except for a darkened right apex, and all outlines clearer thannormal. Diaphragm low down in the chest and its excursion limited on 196 THE ROENTGEN RAYS IN MEDICINE AND SURGERY the upper side. Long axis of the heart nearly vertical; right side en-larged ; little or no difference in position of heart in inspiration Fig. 123. Patrick W. January 17, 1900. Emphysema. First X-ray tracing. Lungs brighterthan normal except for darkened right apex. Diaphragm low down in chest; limited onupper side. Long axis of heart nearly vertical, right side enlarged; little or no difference in positionof heart between inspiration and expiration. (One-third life siEe.) January 30. SecondX-Ray Examination with Screen (X-ray tracingnot given). — Similar outlines to those seen January 17. Eight examinations of the sputa made; no tubercle bacilli found. Discharged February 6. May 13, 1900. Third X-Ray Examination ivith Screen. —T\\q pa-tient came to me at my request for another examination. The apex of EMPHYSEMA OF THE LUNGS. BRONCHITIS 197 the right lung was clear (see Fig. 124), so that it is not improbable thathe had on entrance to the hospital the remains
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