A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
When ready to make the count, mix again thoroughly by shaking; blow
two or three drops of the fluid from the pipet, wipe off its tip, and
then place a small drop (the proper size can be learned only by
experience) upon the disc of the counting chamber. Adjust the cover
immediately. Hold it by diagonal corners above the drop of fluid so
that a third corner touches the slide and rests upon the edge of the
platform. Place a finger upon this corner, and, by raising the finger,
allow the cover to fall quickly into place. If the cover be properly
adjusted, faint concentric lines of the prismatic colors--Newton's
rings--can be seen between it and the platform when the slide is
viewed obliquely. They indicate that the two surfaces are in close
apposition. If they do not appear at once, slight pressure upon the
cover may bring them out. Failure to obtain them is usually due to
dirty slide or cover--both must be perfectly clean and free from dust.
The drop placed upon the disc must be of such size that, when the
cover is adjusted, it nearly or quite covers the disc, and that none
of it runs over into the "ditch." There should be no bubbles upon the
ruled area.
Allow the corpuscles to settle for a few minutes, and then examine
with a low power to see that they are evenly distributed. If they are
not _evenly distributed over the whole disc_, the counting chamber
must be cleaned and a new drop placed in it.
Probably the most satisfactory objective for counting is the special
one-sixth for blood work already mentioned. To {154} understand the
principle of counting, it is necessary to remember that the large
square (400 small squares) represents a capacity of one-tenth of a
cubic millimeter. Find the number of corpuscles in the large square,
multiply by 10 to find the number in 1 c.mm. of the diluted blood, and
finally, by the dilution, to find the number in 1 c.mm. of undiluted
blood. Instead of actually counting all the corpuscles, it is
customary to count those in only a limited number of small squares,
and from this to calculate the number in the large square.
In practice a convenient procedure is as follows: _With a dilution of
1:200, count the cells in 80 small squares, and to the sum add 4
ciphers; with dilution of 1:100, count 40 small squares and add 4
ciphers._ Thus, if with 1:200 dilution, 450 corpuscles were counted,
the total count would be 4,500,000 per c.mm. This method is
sufficiently accurate for all clinical purposes, provided the
corpuscles are evenly distributed and two drops from the pipet be
counted. It is convenient to count a block of 20 small squares in each
corner of the large square. It distribution be even, the difference
between the number of cells in any two such blocks should not exceed
twenty. Corpuscles which touch the upper and left sides should be
counted as if within the squares, those touching the lower and right
sides, as outside, and _vice versâ_.
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