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"We do, by preference; but a six-foot plate would be impossible, so I had a special paper made to the size." There is something singularly fascinating in the appearance of a developing photograph; in the gradual, mysterious emergence of the picture from the blank, white surface of plate or paper. But a skiagraph, or X-ray photograph, has a fascination all its own.
To take, therefore, a skiagraph of a brain through two thicknesses of skull, with our present methods, is an impossibility. Even should the difficulty be overcome, it is very doubtful whether there would be any possibility of discovering diseases of the brain, since diseased tissues, such as cancer, sarcoma, etc., are probably as permeable to the X rays as the normal tissues.
"I have rendered the stomach visible," resumed Kennedy, "made it 'metallic, so to speak, by injecting a solution of bismuth in buttermilk, the usual method, by which it becomes more impervious to the X-rays and hence darker in the skiagraph. I took these pictures not at the rate of fourteen or so a second, like the others, but at intervals of a few seconds.
There are, further, the suture wires in the knee-caps; Sir Morgan Bennett, having looked up the notes of the operation, informs me that he introduced three suture wires into the left patella and two into the right; which is what the skiagraph shows. Lastly, the deceased had an old Pott's fracture on the left side.
When we attempt to skiagraph the thicker portions of the body, for example, the shoulder, the thigh, or the trunk, even the parts consisting only of flesh obstruct the rays to such an extent, by reason of their thickness, that the shadows of the still more dense tissues, like the thigh bone, the arm bone, or the bones of the trunk, cannot be distinguished from the shadows of the thicker soft parts.
The Greek word for shadow is "skia," and the proper rendering, therefore, of shadowgraph is "skiagraph," corresponding to photograph. The first question that meets us in the use of the method in medicine is what normal constituents of the body are permeable or impermeable to the X rays.
It would be manifestly an utter impossibility to skiagraph the many fractures which are seen there daily, considering that it would take from half an hour to an hour of the time of not less than two or three assistants skilled not only in surgery, but also in electricity, to skiagraph a single fracture.
If our methods improve so that we can skiagraph through the entire body, it will be very possible to determine the presence and location of foreign bodies in the stomach and intestines.
That we are not able at present to skiagraph the soft parts of the body, does not imply that we shall not be able to do it hereafter; and should this be possible, especially with our increasing ability to penetrate thick masses of tissue, it is evident, without entering into details, that the use of the X rays may be of immense importance in obstetrics.
At present, if the attempt is made to skiagraph the shoulder or parts of the trunk, we have to deal with organs which cannot be kept motionless, since the movements incident to breathing produce a constant to and fro movement of the shoulder, the lungs, the heart, the stomach, the liver, and other organs which, hereafter, may be made accessible to this process.
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