The Ypsilanti daily press. (Ypsilanti, Mich.) 1928-1962, 1945-02-09

DR.. Clendenlng Will answer
questions Of general interest
only, and then only through
his column.
diagnostie medicine, the other two
being the stethoscope and the mi
croscope. By anyone's calculation
It is one Of the six greatest medica!
discoveries Of all time.
Ii was some time, however, be
fore Us full value was recognized.
. Al first no one grasped how useful
1t would be even IN the diagnosis
Of bone conditions like fractures
and dislocations. Then for ten
years no one ever thought Of using
il in any other field. Then some
kidney stones were seen on a plate,
which opened a new field Of use
fulness. But | went clear through
medical school from 1903 to 1907
without ever seeing an x-ray Of
the chest or abdomen. Some pio-
neer work had been done, but it
was not in general practice.
Now, Of course, X-ray eXamina-
tion of the chest and abdomen are
indispensable for any complete
diHgnostic examination.
The principle of the action Of
the x-ray in the chest is just the
same as that Of the x-ray in de-
lneating the bones the ray shows
differences Of density. The heart
and large vessels in the chest are
Of a greater density than the
lungs, so they show up on an X-ray
plate. The reason this was not
used earlier IN the history Of the
1-ray was simply technical diff
culties. X-ray tubes were not
made with modalities that differ
entiated such relatively soft struc-
lures as the heart and great yes
sells from other soft tissue.
Modern Equipment
With modern equipment the
size Of the heart, whether enlarged
or not, can readily be seen on an
x-rAy plate. Changes in the great
vessel that leads from the heart,
the aorta, such as the dllatation,
known a. aneurism, can be made
out by the x-ray when often they
are completely undetectable by
other means.
But the heart lies 50 catawum-
pus in the chest, not in q nice rec
tangular manner with the four
chambers presenting like pigeon
holes to the front, that further de-
ductions from x-ray studies are
open to as much or more doubt
than can be made by a good eli
nician by looking, feeling and lis
tening to the chest. And. Of
course. the x-ray being visual
and not an auditory instrument,
such things as heart murmurs are
not revealed by the x-rsy at all.
The lungs and their coverings,
the pleura, when attacked by dis
ease inevitably form scar tissue
or other processes which create
greater densities, 80 here again
the Tray will reveal them. But
even more perfected x-ray tubes
had 10 be made to show these than
10 show the heart shadows.
Lung Tuberculosis
In tuberculosis Of the lungs now,
A. we emphasized in articles last
month, the x-ray is the best and
most accurate diagnostic instru-
ment we have. Its percentage Of
error Of omission is less than that
Of all other methods Of examinA-
tion for tuberculosis, temperature,
sputus examination and stetho-
scope. combined. The use Of the
x-ray enables US to go through a
group Of the population and pick
out the cases Of tuberculosis with
only about q one per cent margin
OF errcr. The other methods, how
ever, tell US the degree Of dis
sbility.
In disease Of the pleura with &C
cumulations Of fluid and pus, the
x-ray gives accurate information
about the extent and size OF the
pockets Of fluid.
In summary | should say that
in heart disease the x-ray con-
tributes about 20 per cent of our
diagnostic information. In tuber-
eulosis. about so per cent. In other
conditions, about 80 per cent. We
still reed the clinicisns mind "
interprat the results.