[Frontispiece: PLATE I. Scale of urinary colors, according to Vogel.] A MANUAL OF CLINICAL DIAGNOSIS BY JAMES CAMPBELL TODD, Ph.B., M.D. ASSOCIATE PROFESSOR OF PATHOLOGY, DENVER AND GROSS COLLEGE OF MEDICINE (UNIVERSITY OF DENVER); PATHOLOGIST AND CLINICAL MICROSCOPIST TO MERCY, ST. ANTHONY'S, AND THE DENVER CITY AND COUNTY HOSPITALS Illustrated PHILADELPHIA AND LONDON W. B. SAUNDERS COMPANY 1908 Copyright, 1908, by W. B. Saunders Company PRINTED IN AMERICA PRESS OF W. B. SAUNDERS COMPANY, PHILADELPHIA TO MY FATHER JOE H. TODD, M.D. THESE PAGES ARE AFFECTIONATELY DEDICATED PREFACE This book aims to present a clear and concise statement of the more important laboratory methods which have clinical value, and a brief guide to interpretation of results. It is designed for the student and practitioner, not for the trained laboratory worker. It had its origin some years ago in a short set of notes which the author dictated to his classes, and has gradually grown by the addition each year of such matter as the year's teaching suggested. The eagerness and care with which the students and some practitioners took these notes and used them convinced the writer of the need of a volume of this scope. The methods offered are practical; and as far as possible are those which require the least complicated apparatus and the least expenditure of time. Simplicity has been considered to be more essential than absolute accuracy. Although in many places the reader is given the choice of several methods to the same end, the author believes it better to learn one method well than to learn several only partially. More can be learned from a good picture than from any description, hence especial attention has been given to the illustrations, and it is hoped that they will serve truly to _illustrate_. Practically all the microscopic structures mentioned, all apparatus not in general use, and many of the color reactions are shown in the pictures. Although no credit is given in the text, the recent medical periodicals and the various standard works have been freely consulted. Among authors whose writings have been especially helpful may be mentioned v. Jaksch, Boston, Simon, Wood, Emerson, Purdy, Ogden, Ewald, Ehrlich and Lazarus, Da Costa, Cabot, Osler, Stengel, and McFarland. The author wishes hereby to express his indebtedness to Dr. J. A. Wilder, Professor of Pathology in the Denver and Gross College of Medicine, for aid in the final revision of the manuscript; and to W. D. Engel, Ph.D., Professor of Chemistry, for suggestions in regard to detection of drugs in the urine. He desires to acknowledge the care with which Mr. Ira D. Cassidy has made the original drawings, and also the uniform courtesy of W. B. Saunders Company during the preparation of the book. J. C. T. DENVER, COLORADO, _July, 1908_. CONTENTS INTRODUCTION Use of the Microscope . . . . . . . . . . . . . . . . . . . . . . 17 CHAPTER I