A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
_Diluting Fluids_.--The most widely used are Hayem's and Toisson's.
Both of these have high specific gravities, so that, when well mixed,
the corpuscles do not separate quickly. Toisson's fluid is probably
the better for beginners, because it is colored and can be easily seen
as it is drawn into the pipet. It stains the nuclei of leukocytes
blue, but this is no real advantage. It must be filtered frequently.
HAYEM'S FLUID. TOISSON'S FLUID.
Mercuric chlorid 0.5 Methyl-violet, 5 B 0.025
Sodium sulphate 5.0 Sodium chlorid 1.000
Sodium chlorid 1.0 Sodium sulphate 8.000
Distilled water 200.0 Glycerin 30.000
Distilled water 160.000
{155} _Sources of Error_.--The most common sources of error in making
a blood count are:
(_a_) Inaccurate dilution, either from faulty technic or inaccurately
graduated pipets. The instruments made by Zeiss can be relied upon.
(_b_) Too slow manipulation, allowing a little of the blood to
coagulate and remain in the capillary portion of the pipet.
(_c_) Inaccuracy in depth of counting chamber, which sometimes results
from softening of the cement by alcohol or heat. The slide should not
be cleaned with alcohol nor left to lie in the warm sunshine.
(_d_) Uneven distribution of the corpuscles. This results when the
blood is not thoroughly mixed with the diluting fluid, or when the
cover-glass is not applied soon enough after the drop is placed upon
the disc.
_Cleaning the Instrument_.--The instrument should be cleaned
immediately after using, and the counting chamber and cover must be
cleaned again just before use.
Draw through the pipet, successively, water, alcohol, ether, and air.
This can be done with the mouth, but it is much better to use a rubber
bulb. When the mouth is used, the moisture of the breath will condense
upon the interior of the pipet unless the fluids be shaken and not
blown out. If blood has coagulated in the pipet--which happens when
the work is done too slowly--dislodge the clot with a horse-hair, and
clean with strong sulphuric acid, or let the pipet stand over night in
a test-tube of the acid. Even if the pipet does not become clogged, it
should be occasionally cleaned in this way.
* * * * *
III. COLOR INDEX
This is an expression which indicates the amount of hemoglobin in each
red corpuscle compared with the normal amount. For example, a color
index of 1.0 indicates that each corpuscle contains the normal amount
{156} of hemoglobin; of 0.5, that each contains one-half the normal.
The color index is most significant in chlorosis and pernicious
anemia. In the former it is usually much decreased; in the latter,
generally much increased. In symptomatic anemia it is generally
moderately diminished.
* * * * *
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