The Washington times., 1914-01-27

cent were those in whom the position or
the caecum prohibited its thorough in
spection.
THE following classification covers
the essential points in the findings OF
the average case, so that conclusions
may be drawn that will perrsit dag
nosis to be made: % Functionatins or
non-functionating. C2) Fixed or NOV
able (S) Ascending. descending or
transverse. % Straight, kinked, curved,
looped or dubbed"
Looks Directly at Object.
This is the difference between fIuro-
scopic and photographic examination:
BY the use of the Horoscope the physi-
clan is enabled to look directly at the
object or organ to be examined, or at
least directly at its shadowy outline,
which is sufficiently distinct to indicate
its appearance and normal or abnormal
condition. A photographic examination
means the examination Of the photo
graph or Photographic plate represent
ing that which Is seen directly through
the Horoscope.
Perhaps the most interesting feature
or an X-ray examination OF the abdom-
1naI contents Is the manner in which
the parts under scrutiny are made Wis
ible. They must contain some Opaque
substances which the rays will not pen
out n bold relief from other soft tis-
sues. This is done by giving to the
patient the so-called "bismuth meal"
Hours before the examination is to
be made the patient swallows several
ounces Of the Opaque salts of bismuth.
natural openings are to be found In the
intestines. In a footnote Dr.. Quimby
says:
The Opaque salts used in this work
are bismuth subcarbonate and bariun1
sulphate. II administered In sufficient
doses bismuth subnitrate may be poi
sonous. This Is due to chemical decom-
position resulting in nitrate poisoning.
If not properly washed barium sulphate
may contain barium chloride a soluble
poisonous salt. Conservatively we may
estimate. that in X-ray examinations
0,VO patients have received bismuth
and barium salts with no Ill effects, ex-
cept where barium subnitrate or impure
barlum sulphate was employed
Dr. Quimby says that a function
ating appendix Is capable of receiv-
Ing and discharging intestinal con-
tents. In the human being 1t must be
regarded as part of the intestines
and is, therefore, subject to the same
laws: AS matter of fact, when a
tunctionattng appendix Is subjected
TO microscopic examination it fire.
quently happens that the examining
PhS SiCidh ACTUALLY sees the appendix
receiving and discharging a part OF
the intestinal contents. The same
peristaltic action governs the move
ments of the walls of the fntestines
proper. A few years ago physicians
did not believe that anything could
enter the canal of the appendix IL il
was in normal condition.
Here are DIR. Quimby's conclusions:
Il. When there is chronic constipa-
tion due to delayed or inhibited peri
stalsis the appendix is usually dis
eased.
"2. In the differentiaI diagnosis of
the appendix the X-ray is essential.
3. When the pathological condition
of an appendix is suspected and there
are few symptoms an X-ray finding is
essential.
"a. When the appendix is tied up in
a mass of adhesions an accurate find
ing of the appendix enables the oper-
ator to rapidly locate it at operation.
5. Accurate determination of condi-
tions typifying appendicitis should be
made before operation.
"6. When there are obscure symp-
toms in the abdomen which cannot be
traced to definite organ an X-ray ex-
animation OF the appendix may show
that 1T is adherent to some distant or
gan"