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CT Imaging 1st Edition Alexander C. Mamourian Digital
Instant Download
Author(s): Alexander C. Mamourian
ISBN(s): 9780199987993, 0199987998
Edition: 1
File Details: PDF, 9.30 MB
Year: 2013
Language: english
CT IMAGING
This page intentionally left blank
 CT IMAGING
PRACTICAL PHYSICS,
ARTIFACTS, AND PITFALLS

Editor:
Alexander C. Mamourian MD
Professor of Radiology
Division of Neuroradiology
Department of Radiology
Perelman School of Medicine of the
University of Pennsylvania
Philadelphia, Pennsylvania

Contributors:
Harold Litt MD, PhD Nicholas Papanicolaou MD, FACR
Assoc. Professor of Radiology and Medicine Co-Chief, Body CT Section
Chief, Cardiovascular Imaging Professor of Radiology
Department of Radiology Department of Radiology
Perelman School of Medicine of the Perelman School of Medicine of the
University of Pennsylvania University of Pennsylvania
Philadelphia, Pennsylvania Philadelphia, Pennsylvania

Supratik Moulik MD Josef P. Debbins PhD, PE, DABMP

Fellow, Cardiovascular Imaging Staff Scientist
Department of Radiology Keller Center for Imaging Innovation
Perelman School of Medicine of the Department of Radiology
University of Pennsylvania St. Joseph’s Hospital and Medical Center
Philadelphia, Pennsylvania Phoenix, Arizona

1 2013
 1
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the University’s objective of excellence
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© Oxford University Press 2013

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All rights reserved. No part of this publication may be reproduced,

stored in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise,
without the prior permission of Oxford University Press.

Library of Congress Cataloging-in-Publication Data

CT imaging : practical physics, artifacts, and pitfalls / editor,
Alexander C. Mamourian; contributors, Harold Litt ... [et al.].
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-19-978260-4(pbk. : alk. paper)
I. Mamourian, Alexander C. II. Litt, Harold I.
[DNLM: 1. Tomography, X-Ray Computed. 2. Cardiac Imaging Techniques.
3. Nervous System—radiography. 4. Radiation Dosage. 5. Radiation Protection.
6. Whole Body Imaging. WN 206]
LC Classification not assigned
616.07'5722—dc23
2012038160

1 3 5 7 9 8 6 4 2
Printed in the United States of America
on acid-free paper
 CONTENTS
Introduction vii
Acknowledgements ix
Dedication xi

1 HISTORY AND PHYSICS OF CT IMAGING 1

Alexander C. Mamourian

2 RADIATION SAFETY AND RISKS 35

Alexander C. Mamourian and Josef P. Debbins

3 CARDIAC CT IMAGING TECHNIQUES 55

Supratik Moulik and Harold Litt

4 CARDIAC CT ARTIFACTS AND PITFALLS 71

Supratik Moulik and Harold Litt

5 NEURO CT ARTIFACTS 113

Alexander C. Mamourian

6 NEURO CT PITFALLS 147

Alexander C. Mamourian

7 BODY CT ARTIFACTS 197

Nicholas Papanicolaou

8 BODY CT PITFALLS 215

Nicholas Papanicolaou

9 TEST QUESTIONS 225

Alexander C. Mamourian

Index 233
This page intentionally left blank
 INTRODUCTION
I could say that computed tomography (CT) and my career started together, since the first units arrived
in most hospitals the same year that I entered my radiology residency. But while I knew the physics of
CT well at that time, over the next 30 years CT became increasingly complicated in a quiet sort of way.
While MR stole the spotlight during much of that time, studies that were formerly unthinkable, like CT
imaging the heart and cerebral vasculature, have become routine in clinical practice. But these expand-
ing capabilities of CT have been made possible by increasingly sophisticated hardware and software.
And while most manufacturers provide a clever interface for their CT units that may lull some into
thinking that things are under control, the user must understand both the general principles of CT as
well as the specific capabilities of their machine because of the potential to harm patients with X-rays.
For example, it was reported not long ago that hundreds of patients received an excessive X-ray dose
during their CT brain perfusion exams. Although that was troubling enough, the unusually high dose
was eventually attributed in some share to the well-meaning but improper use of software commonly
used to reduce patient X-ray dose but only for specific applications that do not include perfusion.
This book was never intended to be the defi nitive text on the history, physics, and techniques of CT
scanning. Our goal was to offer a collection of useful advice taken from our experience about modern
CT imaging for an audience of radiology residents, fellows, and technologists. It was an honor and a
pleasure to work with my co-authors, an all-star cast of experts in this field, and it is our collective
hope you will fi nd this book helpful in the same way that the owner’s manual that comes with a new
car is helpful; not enough information to rebuild the engine, but what you need to reset the clock when
daylight saving rolls around or change the oil. Many experienced CT users will very likely fi nd some
things useful here as well.
The review of CT hardware in Chapter 1 should get you off to a good start since the early scanners
were just simpler and for that reason easier to understand. The following chapters build on that foun-
dation. Chapter 2 provides a review of the language of X-ray dose and dose reduction, followed by a
comprehensive description of the advanced techniques used for cardiac CT in Chapter 3. Feel free at
any time to explore the cases in Chapters 4 through 8. Most of these include discussions of practical
physics appropriate to that particular artifact or pitfall. In the fi nal chapter, you will fi nd 10 questions
that will test your understanding of CT principles. Take it at the start or at the end to see how you
stand on this topic. While there is a rationale to the arrangement of the book you may want to keep
it nearby and go to appropriate chapters for those questions that may arise about CT dose, protocols,
and artifacts in your daily practice.
If you get nothing else from reading this book, you should be sure to learn the language of CT dose
explained in Chapter 2. Understanding radiation dose specific to CT has become more important
than ever in this time of increasing patient awareness, CT utilization, and availability of new software
tools for dose reduction. We hope that this book will help you to create the best possible CT images,
at the lowest possible dose, for your patients.
This page intentionally left blank
 ACKNOWLEDGMENTS
I want to thank Cheryl Boghosian and Neil Roth in New Hampshire, for their wonderful hospitality,
generous spirit, and faithful friendship over many years, and most recently for giving me the time and
space to fi nish this book. My sincere thanks also go to Andrea Seils at Oxford Press. Every writer
should be blessed with an editor of her caliber. I will be forever grateful to Dr. Robert Spetzler and
all the staff at the Barrow Neurological Institute for giving me the inspiration and the opportunity to
write at all.
This page intentionally left blank
 DEDICATION
I dedicate this book to my parents, Marcus and Maritza, who have given unselfi shly of themselves to
so many.
To Pamela, Ani, Molly, Elizabeth, and Marcus, I can fi nd no words that can express my endless
affection and gratitude.
This page intentionally left blank
1 HISTORY AND PHYSICS OF
CT IMAGING
Alexander C. Mamourian
2 CT IMAGING

The discovery of X-rays over 100 years ago by Wilhelm Roentgen marks the stunning beginning of
the entire field of diagnostic medical imaging. While the impact of his discovery on the fields of phys-
ics and chemistry followed, the potential for medical uses of X-rays was so apparent from the start
that, within months of his fi rst report, the fi rst clinical image was taken an ocean away in Hanover,
New Hampshire. A photograph of that particular event serves as a reminder of how naïve early users
of X-ray were with regard to adverse effects of radiation (Figure 1.1). We can only hope that our
grandchildren will not look back at our utilization of CT in quite the same way.
Although plain X-ray images remain the standard for long bone fractures and preliminary chest
examinations, they proved to be of little value for the diagnosis of diseases involving the brain, pel-
vis, or abdomen. This is because conventional X-ray images represent the net attenuation of all the
tissue between the X-ray source and the fi lm (Figures 1.2–1.4).
This inability to differentiate tissues of similar density on X-ray is due in part to the requirement for
the X-ray beam to be broad enough to cover all the anatomy at once. As a result of this large beam,
many of the X-rays that are captured on film have been diverted from their original path into other
directions, and these scattered X-rays limit the contrast between similar tissues. This problem was well
known to early imagers, and, prior to the invention of computed tomography (CT), a number of solu-
tions were proposed to accentuate tissue contrast on X-ray images. The most effective of these was a
device that linked the X-ray tube and film holder together, so that they would swing back and forth in
reciprocal directions on either side of patient, around a single pivot point. This was effective to some

Figure 1.1 This photograph captures the spirit of early X-ray exams. Note the pocket watch used to time the exposure (left ) and the
absence of any type of radiation protection for the patient or observers. The glowing cathode ray tube (positioned over the arm of
the patient, who is sitting with his back to the photographer) was borrowed from the department of physics at Dartmouth College. As
rudimentary as this apparatus might appear, it was effective in demonstrating the patient’s wrist fracture. Image provided courtesy of
Dr. Peter Spiegel, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
 History and Physics of CT Imaging 3

(A) (B)

Film

Net attenuation
X-ray
1 1 20 1 1 24
beam

X-ray
5 4 5 5 5 24
beam

Figure 1.2 While X-ray images (A) are useful for demonstrating contrast between bone, soft tissue, and air, they are not effective at
showing contrast between tissues of similar attenuation. In this image, the pancreas, liver, and kidneys cannot be identified separately
because they all blend with nearby tissues of similar density. That is in part because the flat X-ray image can only show the net attenu-
ation of all the tissues between the X-ray source and the film or detector. This is illustrated mathematically in B, where these two rows
of blocks of varying attenuation would nevertheless have the same net attenuation on a conventional X-ray image.

degree because it created blurring of the tissues above and below the pivot plane (Figure 1.5), and this
technique became know as simply tomography. When I was a resident, we used several variations of
this technique for imaging of the kidneys and temporal bones to good effect since the tissues in the
plane of the pivot point were in relatively sharp focus, at least sharper than conventional X-rays.
Computed tomography proved to be much more than an incremental advance over simple X-ray
tomography, however. That is because it both improved tissue contrast and, for the fi rst time, allowed
imagers to see the patient in cross-section. The remarkable sensitivity to tissue contrast offered by
CT was in some sense serendipitous since it was the byproduct of the use a very narrow X-ray beam
for data collection (Figure 1.6). This narrow beam, unlike the wide X-ray beam used for plain fi lms,
significantly reduces scatter radiation. For physicians familiar with conventional X-ray images, those
early CT images were really just as remarkable as Roentgen’s original X-ray images.
The benefits offered by CT imaging to health care was formally acknowledged with the 1979
Nobel Prize for medicine going to Godfrey Hounsfield, just 6 years after his fi rst report of it. The
prize was shared with Allan Cormack, in recognition of his contributions to the process of CT image
reconstruction. But this prestigious award was not necessary to bring public attention to this new
imaging device. At the time the Nobel was awarded, there were already over 1,000 CT units operat-
ing or on order worldwide.
At the time of his discovery, Godfrey Hounsfield was employed by a British fi rm called EMI
(Electrical and Musical Industries) that had interests in both music and musical hardware. While
EMI is better known now for its association with both Elvis Presley and the Beatles, it was much
more than a small recording company with some good fortune in signing future stars. EMI manu-
factured a broad range of electrical hardware, from record players to giant radio transmitters, and
4 CT IMAGING

Figure 1.3 and 1.4 Another significant limitation of plain film is that there is no indication of depth even when sufficient image
contrast is present. For example, on this single plain film of the skull it appears at first glance that this patient’s head is full of metal
pins (1.3). This is because an X-ray image is just a two-dimensional representation of a three-dimensional object, and each point on
the image reflects the sum attenuation of everything that lies between the X-ray source and that point on the film. While you can easily
see that there are a large number of metal pins superimposed on the skull in this example, you cannot tell whether they are on top of
the skull, behind the skull, or inside the skull (perhaps from some terrible industrial accident). The computed tomography (CT) image
of this patient shows that they are, fortunately, hairpins that are outside the skull (Figure 1.4; arrows).

a fortuitous and unusual combination of broad interests in electronics with substantial financial
support offered by its music contracts apparently gave Hounsfield the latitude necessary for his
distinctly unmusical research into CT imaging. In his lab, he built a device intended to measure the
variations in attenuation across a phantom using a single gamma ray source and single detector.
Gamma rays are, of course, naturally occurring radiation, and so the fi rst device he built did not use
an X-ray tube at all but a constrained radioactive element.
By measuring precisely how much the phantom attenuated the gamma rays in discrete steps from
side to side, and then repeating those measurements in small degrees of rotation around the object,
Hounsfield showed that it was possible to recreate the internal composition of a solid phantom
using exclusively external measurements. While CT is commonplace now, at the start this capabil-
ity to see inside opaque objects must have seemed analogous to Superman’s power to see through
solid walls. That large dataset collected by Hounsfield’s device was then converted into an image
using known mathematical calculations (Figures 1.7, 1.8) with the aid of a computer of that era.
Computed tomography was initially considered to be a variation of existing tomography, so it was called
“computed” tomography, or more accurately computed axial tomography aka CAT scanning. This acro-
nym was commonly a source of humor when confused with the pet (no pun intended), and eventually it
was shortened to just “CT.” Hounsfield was honored for the creation of this remarkable imaging tool by
having the standard unit of CT attenuation named a “Hounsfield unit,” which is abbreviated HU.
 History and Physics of CT Imaging 5

Figure 1.5 This drawing from a patent illustration shows the complex mechanics of a tomography device. In this design, the X-ray
tube is under the patient table and the film above. The belt at the bottom drives the to-and-fro movement of the entire apparatus. From
AG Filler. The history, development and impact of computed imaging in neurological diagnosis and neurosurgery: CT, MRI, and DTI.
Doi:10.103/npre.2009.3267.5

The medical implications of his device were quite evident to Hounsfield from his earliest experi-
ments, and EMI was supportive of his research in this direction. As the invention moved into a
clinical imaging tool, the mathematical reconstruction used for initial experiments proved to be too
time-consuming using the computers available at that time. Faster reconstruction was essential for
clinical use and, in recognition of his research that contributed to the faster reconstruction speeds
for CT, Allan Cormack was also recognized with a share of the 1979 Nobel Prize.
In common with many scientific advances, Cormack’s investigations preceded the invention of CT
imaging by many years. It was twenty years prior to Hounsfield’s work, after the resignation of
the only other nuclear physicist in Capetown, South Africa, that Cormack became responsible for
the supervision of the radiation therapy program at a nearby hospital. Without a dedicated medical
background, he brought a fresh perspective on his new responsibilities and was puzzled at the usual
therapy planning process used at that time. It presumed that the human body was homogeneous as far
as X-rays are concerned, when it clearly was not. He thought that if the tissue-specific X-ray attenua-
tion values for different tissues were known, it would eventually be of benefit not only for therapy but
also for diagnosis. He eventually published his work on this subject in 1963, nearly a decade prior to
Hounsfield’s first report of his CT device. In his Nobel acceptance lecture, Cormack reflected that,
immediately after the publication of his work, it received little attention except from a Swiss center for
avalanche prediction that hoped it would prove to be of value for their purposes. It did not.
6 CT IMAGING

Figure 1.6 This early CT of the brain allowed the imager to see the low attenuation CSF within the ventricles as well as the high
attenuation calcifications in the ventricular wall in this patient with tuberous sclerosis.

Axial Versus Helical Imaging

While early CT scanners were quite remarkable in their time, they were really quite slow as they went
about their businesslike “translate-rotate” method of data collection. For example, it took about
5 minutes to accumulate the data for two thick (>10mm) slices of the brain at an 80 ×80 matrix.
While still remarkable at that time, these scanners were deemed inadequate for much else apart from
brain imaging.
Even with their limitations, early EMI CT scanners were very expensive, costing about $300,000
dollars even in 1978, and that got the attention of many other manufacturers around the world. It
became a race among them to establish a foothold in this lucrative new market. As a result of this
concerted effort, CT scan times dropped rapidly as manufacturers offered faster and better units; as
a result, it was not long before EMI was left behind.
Those fi rst-generation scanners were made obsolete by faster “second-generation” units that used
multiple X-ray sources and detectors. Not long afterward, these second-generation scanners were
surpassed by scanners using what we call “third-generation” design, which eliminated the “trans-
late” movement. Now the X-ray fan beam, along with its curved detector row (Figure 1.9), could
spin around the patient without stopping. That design still remains the preferred arrangement on
current scanners since it readily accommodates large X-ray tubes, both axial and helical imaging,
and wide detector arrays. Since they spin together, the large detector arrays nicely balance the large
X-ray tubes.
 History and Physics of CT Imaging 7

Figure 1.7 Hounsfield’s patent on CT included an illustration (upper left drawing labeled A) of the lines of data that were collected
in a translate-rotate pattern, shown here for only three different angles. From AG Filler. The history, development and impact of com-
puted imaging in neurological diagnosis and neurosurgery: CT, MRI, and DTI. Doi:10.103/npre.2009.3267.5

On the early CT units, the only technique of imaging available was what we now call axial mode
or step-and-shoot. The later term better captures the rhythm of axial mode imaging since all the
data necessary for a single slice is collected (shoot) in a spin before the patient is moved (step) to the
next slice position. While axial mode has advantages in some circumstances and is still available
on scanners, it takes more time than helical scanning since the stepwise movement of the patient is
time-consuming relative to the time spent actually scanning.
On early scanners with only a single detector row, the act of decreasing slice thickness by half
would result in doubling the scan time. That is because scanning the same anatomy but with thinner
sections was just like walking but taking smaller steps. The process of acquiring single axial scans
had other limitations and many were due the relatively long scan time. For example, if there were
any patient motion during acquisition of those single scans, misregistration or steps would appear
between slices on reconstruction (Figure 1.10).
This aversion to patient motion during axial CT scanning, imprinted on imagers for over a decade,
made the spiral CT technique all the more remarkable when it was introduced in 1990. Now, patient
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The Project Gutenberg eBook of The cup; and
The falcon
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Title: The cup; and The falcon

Author: Baron Alfred Tennyson Tennyson

Release date: December 4, 2023 [eBook #72318]

Language: English

Original publication: London: MacMillan and Co, 1884

Credits: Charlene Taylor and the Online Distributed

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*** START OF THE PROJECT GUTENBERG EBOOK THE CUP;

AND THE FALCON ***
 THE CUP
AND
THE FALCON

THE CUP
AND
THE FALCON

BY
ALFRED
LORD TENNYSON
POET LAUREATE

London
MACMILLAN AND CO.
1884
 THE CUP
A TRAGEDY

“The Cup” was produced at the Lyceum Theatre, under the

management of Mr. Henry Irving, January 3, 1881, with
the following cast:—
GALATIANS.

Synorix, an ex-Tetrarch Mr. Henry Irving.

Sinnatus, a Tetrarch Mr. Terris.
Attendant Mr. Harwood.
Boy Miss Brown.
Maid Miss Harwood.
Phœbe Miss Pauncefort.
Camma, wife of Sinnatus, afterwards Priestess
in the Temple of Artemis Miss Ellen Terry.

ROMANS.

Antonius, a Roman General Mr. Tyars.

Publius Mr. Hudson.
Nobleman Mr. Matheson.
Messenger Mr. Archer.

ACT I.

Scene I. —Distant View of a City of Galatia. (Afternoon.)

” II. —A Room in the Tetrarch’s House. (Evening.)
” III. —Same as Scene I. (Dawn.)

ACT II.
Scene —Interior of the Temple of Artemis.
 ACT I.
Scene I.—Distant View of a City of Galatia.

As the curtain rises, Priestesses are heard singing in the Temple.

Boy discovered on a pathway among Rocks, picking grapes. A
party of Roman Soldiers, guarding a prisoner in chains, come
down the pathway and exeunt.

Enter Synorix (looking round). Singing ceases.

Synorix.

Pine, beech and plane, oak, walnut, apricot,

Vine, cypress, poplar, myrtle, bowering-in
The city where she dwells. She past me here
Three years ago when I was flying from
My Tetrarchy to Rome. I almost touch’d her—
A maiden slowly moving on to music
Among her maidens to this Temple—O Gods!
She is my fate—else wherefore has my fate
Brought me again to her own city?—married
Since—married Sinnatus, the Tetrarch here—
But if he be conspirator, Rome will chain,
Or slay him. I may trust to gain her then
When I shall have my tetrarchy restored
By Rome, our mistress, grateful that I show’d her
The weakness and the dissonance of our clans,
And how to crush them easily. Wretched race!
And once I wish’d to scourge them to the bones.
But in this narrow breathing-time of life
Is vengeance for its own sake worth the while,
If once our ends are gain’d? and now this cup—
I never felt such passion for a woman.
 [Brings out a cup and scroll from
under his cloak.

What have I written to her?

[Reading the scroll.

“To the admired Camma, wife of Sinnatus, the Tetrarch, one

who years ago, himself an adorer of our great goddess, Artemis,
beheld you afar off worshipping in her Temple, and loved you for
it, sends you this cup rescued from the burning of one of her
shrines in a city thro’ which he past with the Roman army: it is
the cup we use in our marriages. Receive it from one who
cannot at present write himself other than
“A Galatian serving by force in the Roman Legion.”

[Turns and looks up to Boy.

Boy, dost thou know the house of Sinnatus?

Boy.

These grapes are for the house of Sinnatus—

Close to the Temple.

Synorix.

Yonder?

Boy.

Yes.

Synorix (aside).

That I
With all my range of women should yet shun
To meet her face to face at once! My boy,
 [Boy comes down rocks to him.

Take thou this letter and this cup to Camma,

The wife of Sinnatus.

Boy.

Going or gone to-day

To hunt with Sinnatus.

Synorix.

That matters not.

Take thou this cup and leave it at her doors.

[Gives the cup and scroll to the Boy.

Boy.

I will, my lord.

[Takes his basket of grapes and exit.

Enter Antonius.

Antonius (meeting the Boy as he goes out).

Why, whither runs the boy?

Is that the cup you rescued from the fire?

Synorix.

I send it to the wife of Sinnatus,

One half besotted in religious rites.
You come here with your soldiers to enforce
The long-withholden tribute: you suspect
This Sinnatus of playing patriotism,
Which in your sense is treason. You have yet
No proof against him: now this pious cup
Is passport to their house, and open arms
To him who gave it; and once there I warrant
I worm thro’ all their windings.

Antonius.

If you prosper,
Our Senate, wearied of their tetrarchies,
Their quarrels with themselves, their spites at Rome,
Is like enough to cancel them, and throne
One king above them all, who shall be true
To the Roman: and from what I heard in Rome,
This tributary crown may fall to you.

Synorix.

The king, the crown! their talk in Rome? is it so?

[Antonius nods.

Well—I shall serve Galatia taking it,

And save her from herself, and be to Rome
More faithful than a Roman.

[Turns and sees Camma coming.

Stand aside,
Stand aside; here she comes!

[Watching Camma as she enters with

her Maid.

Camma (to Maid).

Where is he, girl?

Maid.

You know the waterfall

That in the summer keeps the mountain side,
But after rain o’erleaps a jutting rock
And shoots three hundred feet.

Camma.

The stag is there?

Maid.

Seen in the thicket at the bottom there

But yester-even.

Camma.

Good then, we will climb

The mountain opposite and watch the chase.

[They descend the rocks and exeunt.

Synorix (watching her).

(Aside.) The bust of Juno and the brows and eyes

Of Venus; face and form unmatchable!

Antonius.

Why do you look at her so lingeringly?

Synorix.

To see if years have changed her.

Antonius (sarcastically).

Love her, do you?

Synorix.
I envied Sinnatus when he married her.

Antonius.

She knows it? Ha!

Synorix.

She—no, nor ev’n my face.

Antonius.

Nor Sinnatus either?

Synorix.

No, nor Sinnatus.

Antonius.

Hot-blooded! I have heard them say in Rome,

That your own people cast you from their bounds,
For some unprincely violence to a woman,
As Rome did Tarquin.

Synorix.

Well, if this were so,

I here return like Tarquin—for a crown.

Antonius.

And may be foil’d like Tarquin, if you follow

Not the dry light of Rome’s straight-going policy,
But the fool-fire of love or lust, which well
May make you lose yourself, may even drown you
In the good regard of Rome.

Synorix.
 Tut—fear me not;
I ever had my victories among women.
I am most true to Rome.

Antonius (aside).

I hate that man!

What filthy tools our Senate works with! Still
I must obey them. (Aloud.) Fare you well.

[Going.

Synorix.

Farewell!

Antonius (stopping).

A moment! If you track this Sinnatus

In any treason, I give you here an order

[Produces a paper.

To seize upon him. Let me sign it. (Signs it.) There

“Antonius leader of the Roman Legion.”

[Hands the paper to Synorix. Goes

up pathway and exit.

Synorix.

Woman again!—but I am wiser now.

No rushing on the game—the net,—the net.
[Shouts of “Sinnatus! Sinnatus!” Then horn.
Looking off stage.] He comes, a rough, bluff, simple-looking
fellow.
If we may judge the kernel by the husk,
Not one to keep a woman’s fealty when
Assailed by Craft and Love. I’ll join with him:
I may reap something from him—come upon her
Again, perhaps, to-day—her. Who are with him?
I see no face that knows me. Shall I risk it?
I am a Roman now, they dare not touch me.
I will.

Enter Sinnatus, Huntsmen and hounds.

Fair Sir, a happy day to you!

You reck but little of the Roman here,
While you can take your pastime in the woods.

Sinnatus.

Ay, ay, why not? What would you with me, man?

Synorix.

I am a life-long lover of the chase,

And tho’ a stranger fain would be allow’d
To join the hunt.

Sinnatus.

Your name?

Synorix.

Strato, my name.

Sinnatus.

No Roman name?

Synorix.

A Greek, my lord; you know

That we Galatians are both Greek and Gaul.
 [Shouts and horns in the distance.

Sinnatus.

Hillo, the stag! (To Synorix.) What, you are all unfurnish’d?
Give him a bow and arrows—follow—follow.

[Exit, followed by Huntsmen.

Synorix.

Slowly but surely—till I see my way.

It is the one step in the dark beyond
Our expectation, that amazes us.

[Distant shouts and horns.

Hillo! Hillo!

[Exit Synorix. Shouts and horns.

Scene II.—A Room in the Tetrarch’s House.

Frescoed figures on the walls. Evening. Moonlight outside. A couch

with cushions on it. A small table with flagon of wine, cups, plate
of grapes, etc., also the cup of Scene I. A chair with drapery on
it.

Camma enters, and opens curtains of window.

Camma.

No Sinnatus yet—and there the rising moon.

[Takes up a cithern and sits on couch.

Plays and sings.

“Moon on the field and the foam,

 Moon on the waste and the wold,
Moon bring him home, bring him home
Safe from the dark and the cold,
Home, sweet moon, bring him home,
Home with the flock to the fold—
Safe from the wolf”——

(Listening.) Is he coming? I thought I heard

A footstep. No not yet. They say that Rome
Sprang from a wolf. I fear my dear lord mixt
With some conspiracy against the wolf.
This mountain shepherd never dream’d of Rome.
(Sings.) “Safe from the wolf to the fold”——
And that great break of precipice that runs
Thro’ all the wood, where twenty years ago
Huntsman, and hound, and deer were all neck-broken!
Nay, here he comes.

Enter Sinnatus followed by Synorix.

Sinnatus (angrily).

I tell thee, my good fellow,

My arrow struck the stag.

Synorix

But was it so?

Nay, you were further off: besides the wind
Went with my arrow.

Sinnatus.

I am sure I struck him.

Synorix.

And I am just as sure, my lord, I struck him.

(Aside.) And I may strike your game when you are gone.

Camma.

Come, come, we will not quarrel about the stag.

I have had a weary day in watching you.
Yours must have been a wearier. Sit and eat,
And take a hunter’s vengeance on the meats.

Sinnatus.

No, no—we have eaten—we are heated. Wine!

Camma.

Who is our guest?

Sinnatus.

Strato he calls himself.

[Camma offers wine to Synorix, while

Sinnatus helps himself.

Sinnatus.

I pledge you, Strato.

[Drinks.

Synorix.

And I you, my lord.

[Drinks.

Sinnatus (seeing the cup sent to Camma).

What’s here?
 Camma.

A strange gift sent to me to-day.

A sacred cup saved from a blazing shrine
Of our great Goddess, in some city where
Antonius past. I had believed that Rome
Made war upon the peoples not the Gods.

Synorix.

Most like the city rose against Antonius,

Whereon he fired it, and the sacred shrine
By chance was burnt along with it.

Sinnatus.

Had you then

No message with the cup?

Camma.

Why, yes, see here.

[Gives him the scroll.

Sinnatus (reads).

“To the admired Camma,—beheld you afar off—loved you—

sends you this cup—the cup we use in our marriages—cannot
at present write himself other than
“A Galatian serving by force in the Roman Legion.”

Serving by force! Were there no boughs to hang on,

Rivers to drown in? Serve by force? No force
Could make me serve by force.

Synorix.
 How then, my lord?
The Roman is encampt without your city—
The force of Rome a thousand-fold our own.
Must all Galatia hang or drown himself?
And you a Prince and Tetrarch in this province——

Sinnatus.

Province!

Synorix.

Well, well, they call it so in Rome.

Sinnatus (angrily).

Province!

Synorix.

A noble anger! but Antonius

To-morrow will demand your tribute—you,
Can you make war? Have you alliances?
Bithynia, Pontus, Paphlagonia?
We have had our leagues of old with Eastern kings.
There is my hand—if such a league there be.
What will you do?

Sinnatus.

Not set myself abroach

And run my mind out to a random guest
Who join’d me in the hunt. You saw my hounds
True to the scent; and we have two-legg’d dogs
Among us who can smell a true occasion,
And when to bark and how.

Synorix.
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