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If you have double the square inches of emulsion (double sided film) then you need to replenish x2.
Developer replenishment aims mainly at the redox-reaction.
X-ray photons are much less absorbed by silver-halides than are light photons. To gain speed medical X-ray films should have more halide. For coating and developing issues that amount is divided between two opposite layers.
However with the introdution of the fluorescent foils the share of X-rays on exposure is greatly reduced.
Furthermore is that concept of double-coating abandonned for some film types to gain sharpness.
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