The time of exposure was reduced by the use of a fluorescent screen in conjunction with the photographic plate.
207. A woman was troubled with a stiffened wrist. Dr. Morton took a single sciagraph of both wrists side by side as shown at page [174], (the photographic print being presented for this book by E. B. Meyrowitz, 104 East 23d Street, N.Y.) The injured wrist in the picture exhibited the Colles’ Fracture—the ulna and radius bones being telescoped into their fractured ends by a fall upon the sidewalk a year before. By knowing the cause, the manner of cure became evident, and, accordingly, the patient is expected to bend the wrist backward and forward and laterally several times a day.
From sciagraph of club foot of child by Prof. Goodspeed. Copyright, ’96, by William Beverley Harison, Pub. of X-ray pictures, New York. This linograph (woodcut), engraved and donated by Stephen J. Cox, Downing Building, 108 Fulton St., New York, affords an exact likeness of the sciagraph,—well-nigh impossible by an untouched half-tone.
Dr. Morton, in a lecture before the Medical Society of the County of New York, to be printed in the Medical Record, related that another promising field of research and application is in the detection of calcareous infiltrations involving, for instance, the arteries, or occurring in the lungs and other tissues. Calculi in kidneys, in the bladder, in the salivary ducts have already been successfully located. The stages of ossification, and the epiphyseal relations of the osseous structure in children may be pictured as is demonstrated in the picture of the entire skeleton of an infant five months of age. The sciagraph shows plainly that it will be possible to detect spinal diseases, either in children or in adults. (Not reproduced.)
208. Norton’s Experiment. Diagnosis. Elect. World, N.Y., May 23, ’96.—In conjunction with Dr. Francis H. Williams, Dr. Norton examined several patients from the city hospital to determine how an X-ray diagnosis would agree with that previously made by the hospital staff. (See also [§ 142], at end.) The outline of an enlarged liver, 7 inches in diameter, was easily distinguished, the two outlines, one by percussion and one by X-rays, agreeing better in favor of the latter by 1/2 inch. An enlarged spleen was perfectly outlined. The tuberculosis of one lung caused it to be more opaque than the sound lung. It was found necessary to take into account the seams of clothing, buttons, buckles, etc. A bullet was found exactly under the spot which they marked as being over the bullet. A foreign metallic body can be easily detected in the œsophagus, because the latter is quite transparent. They could see the shadows of the cartilaginous rings in the trachea, glottis, and epiglottis. Younger persons, up to 10 years of age, are more transparent than older.
209. Lannelongue, Barthelemy and Oudin’s Experiments. Osteomyelitis Distinguished from Periostitis. Elec. Rev., Lon., Feb. 14, ’96.—In a sciagraph of a person diseased with the former, the surface of the bone was proved to be intact, while the internal parts were destroyed. In the latter disease the changes proceed from the surface to the interior.
The art of sciagraphy, more nearly, as every month passes, becomes developed by means of improved apparatus, screens, photographic plates and other elements which at present are only dimly predicted. Nevertheless, how can a better sciagraph of bones, showing their thickness and porosity, be desired than that reproduced on page [177], and taken by Prof. Arthur W. Goodspeed, and representing a club foot of a child? In the race to excel in this new art, no one, to the author’s knowledge, has surpassed Prof. Goodspeed, of the University of Penn., considered jointly from the standpoints of priority, superiority, quantity and variety. Dr. Keen, L.L.D., Professor in the Jefferson Medical College, of Philadelphia, stated (Inter. Nat. Med. Mag., June, ’96) that Prof. Goodspeed “has far eclipsed all others in these most beautifully clear sciagraphs.”
210. A book could be filled with the numerous cases of diagnosis by X-rays showing the utility. In closing this chapter, let it suffice to mention some of the sources of literature relating to this subject directly or indirectly: location of shot (by Dr. Ashhurst, Phila.) in lady’s wrist, not located by other means. Dr. Packard’s case of acromegaly; Dr. Muller’s (Germantown) location of needle in boy’s foot; cause of pain not before known; needle subsequently removed; a perfect thorax, or trunk, by Prof. Arthur W. Goodspeed, University of Pennsylvania; Thomas G. Morton’s (M. D. Pres. Acad. Surg., Phila.) application to painful affection of the foot, called metatarsaligia. All of the above noticed in Inter. Med. Mag., June, 1896. Case of a burned hand with anchylosis of the fingers, by W. W. Keen, M.D., L.L.D. Bacteria not killed by X-rays. Normal and abnormal phalanx distinguished. Fracture and dislocation sometimes differentiated by X-rays. Amer. Jour. Med. Sci., Mar., ’96.