A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
Wright and his followers regard the opsonic index as an index of the
power of the body to combat bacterial invasion. They claim very great
practical importance for it as an aid to diagnosis and as a guide to
treatment by the vaccine method. This method of treatment consists in
increasing the amount of protective substances in the blood by
injections of normal-salt suspensions of dead bacteria of the same
species as that which has caused and is maintaining the morbid
process, these bacterial suspensions being called "vaccines." The
opinion of the majority of conservative men seems to be that while
vaccine therapy is undoubtedly an important addition to our {202}
methods of treatment of bacterial infections, particularly of those
which are strictly local, yet the value of the opsonic index in
measuring resisting power or as an aid to diagnosis and guide to
treatment is still _sub judice_.
IX. TESTS FOR RECOGNITION OF BLOOD
1. Guaiac Test.--The technic of this test has been given (p. 89). It
may be applied directly to a suspected fluid, or, better, to the
ethereal extract. Add a few cubic centimeters of glacial acetic acid
to about 10 c.c. of the fluid; shake thoroughly with an equal volume
of ether; decant, and apply the test to the ether. In case of dried
stains upon cloth, wood, etc., dissolve the stain in distilled water
and test the water, or press a piece of moist blotting-paper against
the stain, and touch the paper with drops of the guaiac and the
turpentine successively.
[Illustration: FIG. 83.--Teichmann's hemin crystals (Jakob).]
2. Teichmann's Test.--This depends upon the production of
characteristic crystals of _hemin_. It is a sensitive test, and, when
positive, is absolute proof of the presence of blood. A number of
substances--lime, fine {203} sand, iron rust--interfere with
production of the crystals; hence negative results are not always
conclusive. Dissolve the suspected stain in a few drops of normal salt
solution upon a slide. If a liquid is to be tested, evaporate some of
it upon a slide and dissolve the residue in a few drops of the salt
solution. Let dry, apply a cover-glass, and run glacial acetic acid
underneath it. Heat _very gently_ until bubbles begin to form,
replacing the acid as it evaporates. Allow to cool slowly. When cool,
replace the acid with water, and examine for hemin crystals with
two-thirds and one-sixth objectives. The crystals are dark-brown
rhombic plates lying singly or in crosses, and are easily recognized
(Fig. 83). Failure to obtain them may be due to too great heat or too
rapid cooling. If not obtained at first, let the slide stand in a warm
place, as upon a hot-water radiator, for an hour.
X. SPECIAL BLOOD PATHOLOGY
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