Excerpt from The American Journal of Roentgenology, Radium Therapy and Nuclear Medicine, 1927, Vol. 7
With the return of our medical officers from abroad we are hearing tales of the greater prowess of the roentgenologists of Europe in the use of the fluoroscope, and it seems to me that the present is a fitting occasion to remind you of the many advantages of this method of examination.
It has always been a matter of regret that I found so few roentgenologists practicing in this field in spite of the vast amount of work, and of the refinements of technic which have been developed abroad. To these I offer no new additions, and you will find practically everything that I shall speak of to-day fully discussed by Vaquez and Bordet, by Franz M. Groedel, Dietlen, and others. After having used the fluoroscope for a matter of twelve years. I confess to feeling some irritation at finding the teleroentgenogram and the estimation of the cardiac area by planimeter hailed as a great advance over previous methods. This involves no criticism of the very excellent work published by Bardeen (and adopted by the army), or the value of the data which he has accumulated. The present paper is intended in no sense as detracting from the value of this method. My position is simply this: That although a numerical expression for the ratio of the calculated cardiac area to the normal in the case of a particular individual is a valuable asset in the estimation of cardiac disease, if one confines himself to this determination he is neglecting many possible observations which are exceedingly valuable to the discriminating mind in determining the type of disease present in the heart.
To my mind, it is not enough to determine the actual size of the heart. One should also attempt to estimate the relative size of the various chambers of the heart, and as I shall attempt to show, this is virtually impossible by radiographic methods. In addition, it is further possible by direct observation of the cardiac movements to gain some idea of the vigor of the heart muscle itself, of its relation to the remaining structures of the thorax not only in a static but in a dynamic sense.
By means of these observations we are then in a position to assist the internist in a determination not only of the actual size of the heart as a whole, but of its individual chambers and of the functional capacity of the muscle.
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