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of the Surgeon General of the U. S. S. Nizoral 200mg .\. General Hospital No. 19, Oteen. Fig. 2. — Condition of lung after injections of air (Case Ij. and pain will also have a favorable effect upon the morale of the patient, which is Nizoral Hairloss a matter of great importance in the treatment of pulmonary tuber- culosis. The relief of his sufferings is what we strive for. In certain seemingly hopeless cases, this treatment has caused an apparent arrestment of the disease in three selected cases cited in this article. Two of the advanced cases became ambulatory, after the Nizoral Buy patients had been Nizoral Oral bedridden for almost a year. They have shown a great amount of improvement. There are several important factors to be con- sidered before a pneumothorax is tried, and the x ray stands out as the essential guide to the clinician. I must not omit the aid of the fluoroscope, which is also part of the guide. With the bedside unit, Nizoral 2 the hand fluoroscope is used to great advantage. The X ray plates give the pathological findings as a per- manent record, while the fluoroscope gives a clue as to the mobility of the chest and the excursion of the diaphragm of the affected Nizoral 1 side. Nizoral Tablet The following points were studied before pneumothorax was pro- duced : L The extent of the pathology, especially as to cavities. 2. Nizoral Hair Loss Will the opposite lung be able to furnish sufficient pulmonary tissue after the affected lung has been collapsed 2 Nizoral without throwing additional risk to the patient? 3. Pleurisy and adhesions. 1. In the extent of the pathological involvement of the lungs, the x ray stands out as the positive guide. Cavities will always show on the x ray plate, whereas they may be missed by the Nizoral 200 most thorough physical examination (without entering into a discussion of the relative merits of the phys- Nizoral Ketoconazole ical examination ) ; and in deciding the e.xtent of the October 30, 1920.] KRUPF: X RAY A GUIDE IN PNEUMOTHORAX. 671 involvement, I think it has been found that the ront- genological studies are the final and deciding factor. 2. The question of the opposite lung being able to furnish sufficient pulmonary tissue to functionate after the affected kmg has been collapsed, is a seri- ous problem to determine. In a case where one Fig. 3. — X ray of lung prior to injection of air (Case II). lung is involved and the other Ketoconazole Nizoral lung normal, there is no question, of course, that this is the ideal Nizoral Tablets treat- ment. But it is in those cases where both lungs are heavily involved, and perhaps one somewhat less than the other, that the difficulty arises. A careful study of such cases is necessary, before any attempt is made to collapse the lung. Now, what is the course to follow when such is the case and the patient needs relief from his sufferings? In Oral Nizoral all probability this patient is going to die. Therefore we must be governed by the following factors, namely : the cessation of the cough, with a less copious expectoration ; control of the hemorrhages and lessening the toxemia, which otitweighs the risk we take in throwing Hair Loss Nizoral additional burden on the small amount of uninvolved lung tisstie remaining. 3. Adhesions and fibrinous pleurisy Nizoral Hair Growth associated with a pulmonary tuberculosis, as seen by the x ray plate, is another factor to be thoroughly considered, for one cannot attempt to collapse a lung that is firmly plastered to Nizoral Hair the parietal pleura. Of the 453 x ray examinations made in the last three months, forty-six were bedside examinations. I also made use of the hand fluoroscope. The re- maining cases were examined stereoscopically. With this large number of cases to choose from for the production of an artificial pneumothorax, the prob- lem was less difficult. Of the Nizoral Price three selected cases, which I have followed by a series study of x ray plates, the results obtained are here noted and illus- trations given. The cases were given up as hopeless. Two of the patients were bedridden for almost a year and now they are walking about the hospital grounds to a limited extent. The third patient was the worst of the three, because both lungs were heavily involved in addition to the cavities in both upper lobes. By a study of these cases, with the x ray plates and the fluoroscope, Nizoral India an excellent guide

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