November 1, 1898.] 



KNOWLEDGE. 



247 



PROGRESS IN RADIOGRAPHY. 



W 



By .James Quick. 



HEX, at the end of 1h9.j, Rontgen reported the 

 results of his experiments upon the photo- 

 graphic action of those invisible rays he was 

 then working with, he could hardly, perhaps, 

 have anticipated the widespread interest that 

 was evinced upon the subject, or the extensive work that 

 ■ has been done and is now being carried on, throuLfhouf 

 the world. 



Probably few discoveries have been of so much service 

 to scientific workers in general, or have claimed such 

 universal attention, as that of the properties of the Kcintgen 

 rays. 



The selective transmission of the rays being their 

 prominent feature, the most powerful aid was, of course, 

 given to the medical practitioner — especially to the surgeon 

 — in localizing accurately, and without the slightest pain or 

 inconvenience to the patient, any foreign body in the 

 system, especially if that body be of a dense nature, such 

 as lead or steel. 



Radiography has, therefore, become quite a recognized 

 addition to hospital work and to surgeons, and in some 

 cases where the hospital has not been so equipped, 

 systematic work of diagnosis has been undertaken for its 

 physicians by the college or other scientific institution in 

 the same town. Two sets of Kdntgen ray apparatus were 

 also provided for the Sudan expeditionary force. 



The benefit derived by ROntgen's discovery, both to the 

 doctor and to the patient, cannot be over-estimated. Many 

 a patient, having had a foreign body somewhere in his 

 system, or sustained a bone fracture, has afterwards left 

 the hospital showering blessings upon the surgeon for 

 having utilized the radioscopical or radiographical method 

 for extraction or coaptation. 



Every part of the human skeleton has now been success- 

 fully dealt with radiographically, the amount of definition 

 obtainable depending upon the proximity of the part in 

 question to the skin, and therefore to the plate. As the 

 thickness of the tissues through which the rays have to 

 pass increases, so their transparency diminishes, but, 

 according to Batelli, not at an equal or uniform rate, while 

 Vandevyver has shown that the necessary exposure varies 

 as the cube of the thickness of the object, and also depends 

 on the distance (and not on the square; of the distance) 

 between the focus tube and the sensitive plate. 



Not only have X-ray pictures of the various portions of 

 the body been taken at successive exposures and fitted 

 together, but Dr. W.J. Morton has succeeded in obtaining, at 

 one exposure, a life-size radiograph of the entire skeleton 

 of a full-grown living woman — a most remarkable achieve- 

 ment and a striking picture — eveu the heart and other 

 soft tissue organs being visible. The apparatus employed 

 was a twelve-inch coil, worked from a one hundred 

 and seventeen volt cu-cuit. The distance of the focus 

 tube from the plate was four feet six inches, and the time 

 of exposure, including stoppages, thirty minutes. 



In reviewing the work done by medical practitioners in 

 this important and fruitful field for X-ray work, the 

 number of successful cases would make by far too long a 

 list to be adequately dealt with now. It is iu the treat- 

 ment of fractures and luxations, and in the detection and 

 removal of the various calculi and other foreign growths 

 and deposits that the most useful work has been done. 

 Under the best adapted working conditions of apparatus 

 for any particular case, the surgeon can examine with 

 ease the exact condition of a fracture, or caa ascertain how 



far reduction and fixation have been satisfactorily performed 

 — even without disturbing any necessary splints or 

 bandages. No difficulty is experienced with the former 

 if they are made of wood or aluminium, or with the latter 

 provided they are not soaked with lead lotion, or dusted 

 with iodoform, both of which are impervious to the rays. 



Until some twelve months ago, the accurate localization 

 of different foreign bodies in the system was a difficult 

 matter. This question, however, has been taken up — 

 particularly by Mr. Payne and Dr. Mackenzie Davidson — ■ 

 and methods have been devised whereby the examination 

 of any case by the surgeon has been much simplified. 

 That of Dr. Davidson deserves attention as it is so simple 

 and ingenious. With the necessary apparatus the exact 

 position, to one hundredth of an inch, of an object can at 

 once be found, the complicated geometry required by some 

 other methods being simplified down by the apparatus 

 itself and reduced to the application of callipers and a 

 divided scale. Two exposures are made with the focus 

 tube shifted through a certain distance, and the mechanical 

 factors are reconstructed by the employment of fine threads, 

 the position of which corresponds to the path of the 

 X-rays. Fortified with this beautiful method the surgeon 

 can now deal with many cases in much shorter time than 

 was hitherto possible, and interesting reports have come 

 to hand of the localization of bullets in the brain and eye, 

 besides many other results. 



With regard to the various calcareous deposits in the 

 system, localizing the vesical calculi has been from the 

 first a comparatively easy matter. Owing, however, to 

 the position of the kidneys — close to the vertebral column 

 — the depth of the cavity, and the thickness of overlying 

 tissue, it was thought, at the earlier stages of the work, 

 impracticable to obtain a radiograph of renal calcuh, 

 although, in the Laiurt for 11th July, 189G, a case is 

 reported by Dr. J. Macintyre of his having found, radio- 

 graphically, a deposit in the position of the kidneys which, 

 upon operation, proved to be a calcareous mass. A more 

 interesting case, however, of renal calculi is reported by 

 Dr. C, L. Leonard, the age of the patient being nineteen 

 years. The radiograph was made with a twenty minutes' 

 exposure, with the anti-cathode of the vacuum tube placed 

 at a distance of twenty inches from the plate. An eight-inch 

 spark coil was used. The successful operation performed 

 proved the correctness and value of the diagnosis. 



Amongst the many advances that have been made in 

 radiographing the soft tissues, MM. Remy and Contremoulin 

 report having devised a process, based on the deposition 

 of chromate of silver within the tissues of anatomical 

 preparations, which gives striking results in respect of 

 mapping out the structure of the soft parts, while at the 

 same time the bones are more distinctly marked out than 

 they previously have been, so that sesamoid bones hitherto 

 unknown have been discovered. 



The action of Rontgen rays, however, is not only 

 manifested in such cases as instanced above. Experiments 

 show that they exert an influence upon the epidermis 

 of the skin if exposed to them, sometimes causing local 

 inflammation, and this action may occur even deep-seated 

 within the tissues. The heart also, in some cases, appears 

 to be afi'ected when exposed to the action of the rays, in- 

 supportable palpitations and violent and irregular heart 

 beats being produced, necessitating the complete sheltering 

 of the heart by a thick metal shield. 



In chemistry, botany, mineralogy, and other departments 

 their properties have been discovered and applied. Their 

 application to the detection of false gems is now weU known, 

 and a good deal about other allied results are obtained 

 which open up interesting fields for investigation. 



