CLINICAL SYNDROMES (STATUS THYMICUS, ETC.) 419 



9. X-ray exposure of the thymus gland has been proven harm- 

 less, whether in normal or abnormal individuals. A therapeutic 

 test with the X-ray is, therefore, always permissible." 



Friedlander, who has reported a series of over a hundred cases in 

 which only four were unsuccessful, also uses Lange's technic and outlines 

 it thus : 



"A Coolidge tube, backing up a nine and one-half inch spark, was employed. 

 The rays were filtered through 4 mm. of aluminum and a piece of thick leather. 

 The target skin distance was approximately nine inches. The routine exposure 

 was twenty-five milliampere-minutes. In mild cases a single dose given over 

 the anterior surface of the chest proved sufficient. In more urgent cases fifty 

 milliampere-minutes were administered at the first treatment, twenty-five ante- 

 riorly and twenty-five posteriorly. During the treatment the child was kept 

 quiet by four sandbags, one placed across each arm and one across each leg. 

 The interval between treatments was usually one week unless the urgency of 

 the symptoms suggested more frequent application." 



Brayton and Heublein have reported a series of thirty-four cases of 

 enlarged thymus treated with radium, with a prompt disappearance of all 

 symptoms. Their technic is as follows: "100 milligrams of radium 

 element, still in its 0.3 millimeter silver capsule, is wrapped in sufficient 

 gauze so that when strapped to the chest by a strip of adhesive, it will lie 



Fig. 1,3. Before treatment (Brayton and Heublein). 



half an inch from the skin surface. Four marks are made in the form of 

 a rectangle over the thymic area, and the nurse is instructed to allow the 

 package to remain two hours over each mark. This makes a total exposure 

 of 800 milligram-hours. From the moment a diagnosis is made, the 

 child's head should be kept in a flexed position, thus lessening the severity 

 of the asthma and the possibility of sudden death." 



