A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
1. Amoeba Coli Dysenteriæ.--This organism is found, often in large
numbers, in the stools of tropical dysentery and in the pus and walls
of hepatic abscesses associated with dysentery, and is generally
regarded as the cause of the disease. It is a colorless, granular
cell, 20 to 40 µ in diameter (Fig. 91). It contains one or more
distinct vacuoles; a round nucleus, which ordinarily is obscured by
the granules; and frequently red blood-corpuscles and bacteria. When
at rest, its shape is spheric; but upon a warm slide it exhibits the
characteristic ameboid motion, {245} constantly changing its shape or
moving slowly about. This motion is its most distinctive feature.
Other amebæ, resembling the pathogenic variety but smaller (10 to 15 µ
in diameter), are sometimes found in normal feces.
[Illustration: FIG. 91.--Amoeba coli in intestinal mucus, with
blood-corpuscles and bacteria (Lösch).]
When the presence of amebæ is suspected, the stool should be passed
into a warm vessel and kept warm until and during the examination. A
warm stage can be improvised from a plate of copper with a hole cut in
the center. This is placed upon the stage of the microscope, and one
of the projecting ends is heated with a small flame. Amebæ are most
likely to be found in grayish or blood-streaked particles of mucus.
Favorable material for examination can be obtained at one's
convenience by inserting into the rectum a large catheter with roughly
cut lateral openings. A sufficient amount of mucus or fecal matter
will usually be brought away by it.
2. Trichomonas Vaginalis.--The acid discharge of catarrhal vaginitis
sometimes contains this parasite in {246} abundance. It is oval or
pear-shaped, one to three times the diameter of a red blood-corpuscle
in length, and has a cluster of flagella at one end (Fig. 92). It is
not unlike a pus-corpuscle in size and general appearance, but is
actively motile. When in motion the flagella are not easily seen. No
pathogenic significance is ascribed to it. Other varieties of the
genus have been found in the feces, the urine, and the sputum.
[Illustration: FIG. 92.--Trichomonas vaginalis (after Kölliker and
Scanzoni).]
A similar but somewhat smaller organism, _Cercomonas hominis_ (Fig.
93), has been found in the feces in a variety of diarrheal conditions
and in from 10 to 25 per cent. of healthy persons in tropical regions.
[Illustration: FIG. 93.--Cercomonas hominis: A, Larger variety; B,
smaller variety (Davaine).]
In urine or vaginal discharges these organisms might be mistaken for
spermatozoa by one who is entirely unfamiliar with the appearance of
either.
3. Paramoecium Coli (Balantidium Coli).--This parasite is an
occasional inhabitant of the colon of man, and sometimes produces
diarrhea. It is an oval organism, about 0.1 mm. long, is covered with
cilia, and contains {247} a bean-shaped nucleus, two contractile
vacuoles, and variously sized granules (Fig. 94).
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