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85
method of assessment, more particularly in cases undergoing
Sanatorium treatment.
The estimation of Vitamin C excretion in the urine is yet
another method of assessment of activity.
Tomography in Diagnosis.
No branch of medicine owes more to the science of radiology
than the branch concerned with diseases of the chest. The development
and increased utilisation of X-rays in our Chest work has
received full attention in recent annual reports. It is not surprising
that this increase necessarily involves, sooner or later, added
refinements and thus the ingenious method of showing added
detail to that available in the ordinary flat anterior, posterior,
lateral and oblique films, has been introduced, which enable us to
take sectional radiographs of the chest which will no longer
impair the clear vision of the lung parenchyma (such as the
clavicle, caspulaie, ribs, breast shadow in women, etc.). Tomography,
then, enables us to examine sections of the lung in
detail and thus determine the precise depth in the lung parenchyma
from which an area of disease arises. This having been determined,
a close unimpeded study of the area of disease can be
made. The tomograph was originally a very expensive and
elaborate instrument, but thanks to Twining's researches, a
simple comparatively inexpensive appliance has been devised
which can be added to an ordinary X-ray apparatus like our own.
The detailed physics of tomography need not be referred to here,
but the main principle is that the tube and the film holder move in
opposite directions during the exposure. It must, however, be
admitted that the subject is in its infancy, and most general
clinicians recognise that at the present stage it is advisable to
await developments in its refinement, which may ensue with
increased radiological experience. A discussion of tomography
with the Medical Officer of Health and its possible value in our
work both at the Clinic and the Sanatorium, have brought us to a
similar conclusion. The developments will be awaited with
interest.
Artificial Pneumothorax.
Artificial Pneumothorax is now an accepted method of treating
certain selected cases of pulmonary tuberculosis, although in