A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
When the bacilli are scarce, the following method may be tried. It is
applicable also to other fluids. If the fluid is not albuminous, add a
little egg-albumen. Coagulate the albumen by gentle heat and
centrifugalize. The bacilli will be carried down with the albumen.
Separate the albumen, mix with artificial gastric juice (for
preparation of which see test for pepsin, p. 222), and set in an
incubator or warm place until digested. Finally, centrifugalize and
stain as described above. The bacilli do not stain so well as in the
ordinary methods.
A careful search of many smears may be necessary to find the bacilli.
They usually lie in clusters (see Plate V). Failure to find them in
suspicious cases should be followed by inoculation of guinea-pigs;
this is the court of last appeal, and must also be sometimes resorted
to in order to exclude the smegma bacillus.
* * * * *
In gonorrhoea gonococci are sometimes found in the sediment, but more
commonly in the "gonorrheal threads," or "floaters." In themselves,
these threads are by no means diagnostic of gonorrhea. Detection of
the gonococcus is described later (p. 264).
[Illustration: PLATE V. Tubercle bacilli in urinary sediment; X800
(Ogden).]
7. Animal parasites are rare in the urine. Hooklets and scolices of
_Tænia echinococcus_ (Fig. 55) and embryos of _Filaria sanguinis
hominis_ have been met. In Africa the ova, and even adults, of
_Distoma hæmatobium_ are common, accompanying "Egyptian hematuria."
[Illustration: FIG. 55.--1, Scolex of tænia echinococcus, showing
crown of hooklets; 2, scolex and detached hooklets (obj. one-sixth)
(Boston).]
[Illustration: FIG. 56.--Embryo of "vinegar eel" in urine, from
contamination; length, 340 µ; width, 15 µ. An epithelial cell from
bladder and three leukocytes are also shown (studied with Dr. J. A.
Wilder).]
Other parasites, most of which are described in Chapter VI, may be
present from contaminations. A worm {129} which is especially
interesting is _Anguillula aceti_, the "vinegar eel." This is
generally present in the sediment of table vinegar, and may reach the
urine through use of vinegar in vaginal douches, or through
contamination of the bottle in which the urine is contained. It has
been mistaken for _Strongyloides intestinalis_ and for _Filaria
sanguinis hominis_. It closely resembles the former in {130} both
adult and embryo stages. The young embryos have about the same length
as filaria embryos, but are nearly twice as broad and the intestinal
canal is easily seen (compare Figs. 56 and 107).
C. EXTRANEOUS STRUCTURES
The laboratory worker must familiarize himself with the microscopic
appearance of the more common of the numerous structures which may be
present from accidental contamination (Fig. 57).
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