. 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. 113. Simon G. October 17. Cut of third X-ray tracing. Both lungs nearly alike in bright-ness. Diaphragm on left side moves more than at last X-ray examination, but its movement is not yetnormal. This abnormality may be due to pleuritic adhesions. (One-third life size.) PNEUMONIA 183 October 15. Physical signs had all disappeared. Patient out of doorseach day. October 17, 1899. X-Ray Examination with Screen. — Both sidesnearly alike in brightn
. 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. 113. Simon G. October 17. Cut of third X-ray tracing. Both lungs nearly alike in bright-ness. Diaphragm on left side moves more than at last X-ray examination, but its movement is not yetnormal. This abnormality may be due to pleuritic adhesions. (One-third life size.) PNEUMONIA 183 October 15. Physical signs had all disappeared. Patient out of doorseach day. October 17, 1899. X-Ray Examination with Screen. — Both sidesnearly alike in brightness, but it will be seen that the excursion of thediaphragm on the left side was less than half as much as that on theright. (See Fig. 113.) Patient now complains of pain about the left nipple when he sneezes,which is probably due to dry pleurisy, that may limit the expansion ofthe lung and the excursion of the diaphragm. April 21, 1900. The patient returned to the hospital at my request,for a further X-ray examination, the result of which is shown in thefollowing cut. 3jmon in Oep/ lass I I. Fig. 114. Simon G. April 21, 1900. Fourth X-ray tracing. (One-third life size.) Pneumonia with Obscure Physical Signs. — A pneumonia in its earlystages, or even through its whole course, may give no signs by ausculta-tion and percussion, and the physician may find it difficult to make thediagnosis. In some of these cases a doubtful diagnosis may be made amore certain one by the use of the X-rays. This point could be illus-trated by citing a number of cases of central pneumonia, but three willbe sufficient, in which the diagnosis was made clear and definite by anX-ray examination, and in which this diagnosis was confirmed by the 184 THE ROENTGEN RAYS IN MEDICINE AND SURGERY subsequent history of the case; the termination of the fever by a crisis;rusty expectoration; or, in some cases, by the development of physicalsigns of pneumonia as the disease progressed. ChraBCen/rnf Pn
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