A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
_Spirochæte pallida_ is most easily demonstrated in chancres and
mucous patches, although the skin lesions--papules, pustules,
roseolous areas--often contain large numbers. Tissue-juice from the
deeper portions of the lesions is the most favorable material for
examination, because the organisms are commonly more abundant than
upon ulcerated surfaces and are rarely accompanied by other
micro-organisms. After cleansing the surface a superficial incision
with a scalpel or sharp needle is made at the edge of a lesion, or the
surface is gently scraped away with a curet, and a drop of blood and
serum is expressed. The less blood the better, because the {283}
corpuscles may hide the spirochæte. Very thin cover-glass smears are
then made.
Goldhorn's stain gives very good results. It can be purchased ready
prepared from E. Leitz, New York. The unfixed smear is covered with
the stain for four or five seconds. The excess of stain is poured off,
and the preparation introduced _slowly, with the film side down_, into
distilled water. It is held in this position for four or five seconds,
and is then washed by shaking about in the water. By this method the
_Spirochæte pallida_ appears of a violet color, which can be changed
to bluish black by flooding with Gram's iodin solution for fifteen or
twenty seconds. The preparation is then washed, dried, and mounted.
SEMEN
Absence of spermatozoa is a more common cause of sterility than is
generally recognized. In some cases they are present, but lose their
motility immediately after ejaculation.
Semen must be kept warm until examined. When it must be transported
any considerable distance, the method suggested by Boston is
convenient. The fresh semen is placed in a small bottle to the neck of
which a string is attached. This is then suspended from a button on
the trousers so that the bottle rests against the skin of the inguinal
region. It may be carried in this way for hours. When ready to
examine, place a small quantity upon a warmed slide and apply a cover.
The spermatozoa are readily seen with a one-sixth objective (Fig. 53).
Normally, they are abundant and in active motion.
Detection of semen in stains upon clothing, etc., is {284} often
important. The finding of spermatozoa, after soaking the stain for an
hour in normal salt solution or dilute alcohol and teasing in the same
fluid, is absolute proof that the stain in question is semen, although
it is not possible to distinguish human semen from that of the lower
animals in this way.
[Illustration: FIG. 131.--Seminal crystals (medium size) (X750) from a
stain on clothing. A single thread one-eighth inch long was used in
the test, the stain being three years and four months old (Peterson
and Haines).]
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