A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
Salicylates, salol, and similar drugs give a bluish-violet color,
which disappears upon heating, upon addition of a few drops of 10 per
cent. ferric chlorid solution. When the quantity of salicylates is
small, the urine may be acidified with hydrochloric acid and extracted
with ether, the ether evaporated, and the test applied to an aqueous
solution of the residue.
Tannin and its compounds appear in the urine as gallic acid, and the
urine becomes greenish-black (inky, if much gallic acid be present)
when treated with a solution of ferric chlorid.
III. MICROSCOPIC EXAMINATION
A careful microscopic examination will often detect structures of
great diagnostic importance in urine which seems perfectly clear, and
from which only very slight {101} sediment can be obtained with the
centrifuge. Upon the other hand, cloudy urines with abundant sediment
are often shown by the microscope to contain nothing of clinical
significance.
Since the nature of the sediment soon changes, the urine must be
examined while fresh, preferably within six hours after it is voided.
The sediment is best obtained by means of the centrifuge. If a
centrifuge is not available, the urine may be allowed to stand in a
conical test-glass for six to twenty-four hours after adding some
preservative (p. 48). The "torfuge" (Fig. 31) is said to be a very
satisfactory substitute for the centrifuge, and is readily portable.
[Illustration: FIG. 31.--Wetherill's torfuge.]
A small amount of the sediment should be transferred to a slide by
means of a pipet. It is very important to do this properly. The best
pipet is a small glass tube which has been drawn out at one end to a
tip with rather small opening. The tube or glass containing the
sediment is held on a level with the eye, the larger end of the pipet
is closed with the index-finger, which must be dry, and the {102} tip
is carried down into the sediment. By carefully loosening the finger,
but not entirely removing it, a small amount of the sediment is then
allowed to run slowly into the pipet. Slightly rotating the pipet will
aid in accomplishing this. After wiping off the urine which adheres to
the outside, a drop from the pipet is placed upon a clean slide. A
hair is then placed in the drop and a large cover-glass applied. Many
workers use no cover. This offers a thicker layer and larger area of
urine, the chance of finding scanty structures being proportionately
increased. It has the disadvantage that any jarring of the room (as by
persons walking about) sets the microscopic field into vibratory
motion and makes it impossible to see anything clearly; and, since it
does not allow of the use of high-power objectives, one cannot examine
details as one often wishes to do. A large cover-glass with a hair
beneath it avoids these disadvantages, and gives enough urine to find
any structures which are present in sufficient number to have clinical
significance, provided other points in the technic have been right. It
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