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JAMA 100 Years Ago
February 18, 1998

BISMUTH CAPSULES; A NEW APPLICATION OF THE ROENTGEN RAY TO THE DIAGNOSIS OF GASTRO-INTESTINAL AFFECTIONS.

Author Affiliations
 

Edited by Brian P. Pace, MA, Assistant Editor.

JAMA. 1998;279(7):488AC. doi:10.1001/jama.279.7.488

An ordinary gelatin capsule (2.25 by 1.25 cm.) is filled with a non-toxic substance, opaque to the rays (metallic bismuth) and swallowed by the patient. Its varied course throughout the alimentary canal can then be followed with the fluorescent screen or by radiographs. It casts a clear shadow and the importance of the information thus derived in various affections of the stomach and bowels is evident, and also in the study of the effect of various medicaments upon the peristalsis, etc., of the gastro-intestinal tract. The capsule is arrested and lingers for days where there is stenosis of the pylorus or intestines. The interesting communication on the subject in the Deu. Med. Woch. of January 13, is from the eminent authorities, I. Boas and M. Levy Dorn of Berlin, who have tested the capsule on fourteen persons and regard it as a valuable contribution to the study of these viscera from many points of view. The capsule is coated with celluloid to keep it from dissolving and is stained a bright color to enable it to be readily detected in the feces. Powerful rays and a high tension current are needed, and it is well to note whether the shadow is more distinct from the front or rear. With much obesity, they found it impossible to trace the capsule lower than the stomach. In the majority of cases it was found either in the greater curvature, near Bauhin's valve or in the cecum. They never happened to witness its passage through the pylorus. In several cases of slight gastric disturbance the capsule was found after twenty-four hours, invariably in the cecum; less time was required for it to pass through the small intestine to the cecum than for its passage through the pylorus. They are now searching for some substance to coat the capsule that will allow it to be dissolved at will by a chemic agent. They conclude by stating that henceforth a neoplasm or constriction requiring operation can be located with precision by having the patient swallow a capsule as a preliminary to the operation.

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