. 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 . Fig. 142. John y. L. May 29, 1899. Cut of X-ray tracing (one-third life size). Pleurisy with effusionon the right side. Heart displaced to left. Shaded left apex shows a tuberculous area. May 12. — Forty-three ounces of clear fluid aspirated from rightchest. May 18. Physical Examination. — Heart: right border 2 centi-metres to right; left border and apex centimetres to left of medianline; action regular; no murmurs. Lungs: flatness with absent
. 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 . Fig. 142. John y. L. May 29, 1899. Cut of X-ray tracing (one-third life size). Pleurisy with effusionon the right side. Heart displaced to left. Shaded left apex shows a tuberculous area. May 12. — Forty-three ounces of clear fluid aspirated from rightchest. May 18. Physical Examination. — Heart: right border 2 centi-metres to right; left border and apex centimetres to left of medianline; action regular; no murmurs. Lungs: flatness with absent breath-ing and tactile fremitus below mid-scapula in right back ; resonancegood above and in front; respiration slightly harsh, with expirationprolonged. Left side : nothing abnormal found on this side; respira-tion good. PLEURISY WITH EFFUSION. EMPYEMA 227 May 29. X-ray examination zoith screen showed the right sidedark throughout; no diaphragm Hues or ribs seen ; the left apexshaded and the excursion of the diaphragm shortened (Fig. 142). Tubercle bacilli were found in the sputum. NameAddress ^ OccupalioJ ^ Page F2 . Diagnosis. Fig. 143. Andrew J. K. April 12, 1897. First X-ray examination witli screen. Pleurisy witheffusion; much displacement of heart. The amount of fluid present was not as large as the displace-ment of heart and mediastinal contents (see dark curved line in cut) indicated. (Cut one-thirdlife size.) Case III. Andrew J. K., forty-seven years old, entered my ser-vice at the hospital April 10, 1897. Diagnosis : pleurisy with History. — Father died of tuberculosis; mother of cancer. 2 28 THE ROENTGEN RAYS IN MEDICINE AND SURGERY Personal History. — Slight cough for past two years. Present Illness. — More or less pain in left side since November,1896. For five or six weeks, sense of oppression in left chest; for past tendays, constant pain; some dyspnoea; slight cough; no loss of weight. Physical Examination.—Heart: area, actio
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