North Western Tuberculosis Society

North Western Tuberculosis Society A mecting of tile society was held in the Clinical Theatre of tile Manchester Royal Infirmary on Thursday, November -o5, when Dr E. W. Twining, Manchester, gave a demonstration of tomography by simple apparatus, and its clinical applications. Dr Twining took as his major theme the possibilities of tomography in pulmonary diagnosis, and in particular a study of the air vessels, larynx, trachea, and bronchi. He referred to the possibilities of tomography in other fields, especially the skull, spine, and sinuses. By means of a model, he demonstrated the principles of the tomograph, and later his own modification of the apparatus. Dr Twining had adapted the ordinary Potter-Buckey Couch : by means of a horizontal lever connected to the tube column and Potter-Buckey fihn carrier by connecting rods, the tube and film were made to move in opposite directions in the same planO. The axis of the lever could be adjusted for taking tomograms in any selected plane of the object to be examined. Turning to the use oftomography as an aid to diagnosis in pulmonary tuberculosis, Dr Twining expressed his agreement with Dr J. B. McDougall as to its value in demonstrating tim presence of cavities unrevealed by the plain film'. By means of lantern slides and tomograms he demonstrated the value of tomography in defining more clearly than could the ordinary film the septa in pulmonary cavities, the loculi in abscess cavities of the lung, and also the drainage bronchi. He gave a detailed description of the tomographic appearances in malignant disease of the lung. Individual vessels in the lung were clearly revealed by tomography, and their course could easily be followed. This was of value in the diagnosis of such conditions as fibrosis, atelectasis, pressure of intrathoracic neoplasms, the localized effusions, where vessels were often pulled out of their normal course. Dr Twining said that tomography enabled the radiologist to define with accuracy tim lymphatic glands and other components of the hilum, so that the vague term 'thickened roots' could now be amplified. Tomography frequently obviated the necessity for lipiodol injections, particularly in suspected cases of malignant bronchial stenosis, but in bronchiectasis, lipiodol injection was still generally preferred. In conclusion, Dr Twining remarked that as the tomographic apparatus became cheaper, so, no doubt, would its use become a matter of routine. Were it only for its value in showing up lung cavities the tomograph would have earned its place, but in addition, its uses in other fields were obvious. REFERENCES I. TWINING, E. W. -0. McDouGaLL, J. B.

Brit. J. Radiol. 1937, x. 33-0. Use of Tomography, Address given at a meeting of tile Tuherculosis Association, June, 1937.