Roentgenologic Method of Examination of the Lymphatic System in Man and Animals

Abstract

IN 1928, at the suggestion of Professor M. I. Nemenow, the Director of the Institute, our laboratory took up the task of working out a roentgenologic method of examining the lymphatic system. Owing to the fact that there is not a single branch of practical medicine which is not interested in the lymphatic system and considering the importance, the difficulty, and the responsibility of the work, the laboratory set about the task, having included it in the plan of its work as one of the main problems. The first year of work resulted in re-assuring findings, as it enabled us to answer in the affirmative the question as to whether or not it was generally possible to introduce a contrast substance into the lymphatic system of a living animal and to have it reproduced by means of a roentgenogram. The experiments were carried out on frogs, as the introduction of a contrast substance into their large subcutaneous pouches presented no difficulty. The frog was either slightly anesthetized or even received no narcosis whatever, and a number of serial roentgenograms were then made, revealing the penetration of the contrast substance into both the anterior and posterior lymphatic hearts. The frogs bore the experiment well and as a rule survived, so that it was possible to make further roentgenograms at different intervals up to the twenty-first day. In a number of cases the contrast substance having disappeared from the lymphatic hearts, it was observed in the spleen. The findings have been the subject of a special paper.2 Figure 1 is a roentgenogram showing a phase of one of the experiments made Sept. 29, 1928. Animal, Rana temporaria; male; size, average; no narcosis or any other pharmacologic administration. Subcutaneous injection of: (1) 0.3 grm. of Sol. Natr. Brom. 20 per cent, into the right crural region; (2) 0.4 grm. of Bismuth. Carb. Suspens. into the left crural region. The roentgenogram was made 18 seconds later. It shows distinct outlines of a contrast band on the left which spreads from the shin to the lymphatic heart along the whole of the thigh, and a less marked contrast band on the right which is manifest only within its initial limits, spreading no farther than up to the middle of the thigh. Figure 2 is one of the serial roentgenograms showing the experiment carried out on Oct. 27, 1928. Animal, Rana temporaria; male; size, average; small ulcer on the skin of the left upper eyelid; receives neither narcosis nor any pharmacologic administration; subcutaneous injection of 0.1 grm. of Bismuth. Carbo. Suspens. in gum arabic into the left crural region and of the same quantity into the right humeral region. The roentgenogram, taken on Oct. 29, 1928, i.e., in 48 hours' time, reveals the accumulation of the contrast substance in the region of the posterior and anterior lymphatic hearts; no connection with the site of injection can be established.