File:Interstate medical journal (1917) (14597252577).jpg

Identifier: interstatemedica2419unse (find matches)
Title: Interstate medical journal
Year: 1917 (1910s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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dows on platesmade of the right kidney; that is, with the tube anterior and theplate posterior. In approximately 5 or 6 percent of gall-stonesthe calcium deposit may be sufficiently extensive or so uniformhdistributed that the differentiation from renal stones may be diffi-cult; yet this situation does arise with sufficient frequency to requirethat one always be careful to differentiate every case of right renalcalculus from gall-stones. As a proof that this differentiation is sometimes perplexing, Ishall show two plates, one of which is renal calculus, and one ofwhich is gall-stone, and without differentiating them for you, I shallallow you to form your own conclusions as to which is gall-stoneand which is renal stone (Fig. 1, 2). There appears to be a well-disseminated belief that gall-stonesdo not acquire the marked density assumed by renal stones. Aroentgenologist of experience recently, after looking at some plates,remarked to me, Oh! that cant be a gall-stone; it has the density
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948 INTERSTATE MEDICAL JOURNAL of a bullet. If in the beginning we would discard this fallaciousbelief, we should undoubtedly prevent some erroneous diagnoses. As I have stated in a previous paragraph, there is, relativelyspeaking, only a small percentage of stones where the differentiationis difficult, and I am convinced that in the majority of instancesthe use of a little mature deliberation with carefully made platesis all that is necessary for one to arrive at a correct diagnosis.I shall consume no time in this paper in a discussion of the propertube or plate technic to be used in properly made gall-bladder orkidney plates, but I must dwell on this point long enough to saythat, if this part of the examination is properly cared for and onehas clean, sharp, crisp plates to interpret, many differentiationsthat appear to be difficult become simple. In the following tabulation I shall attempt to give you the generalcomparative physical characteristics of gall-stones and kidney stonesâ

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