A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
Wash the finger well and allow a few minutes to elapse for the
circulation to become normal. Prick the finger lightly with a
blood-lancet, regulating the depth of the puncture so that the blood
will not flow without gentle pressure. Quickly dip a clean glass rod
into a vessel containing diluting and fixing fluid, and place two or
three good-sized drops upon the {167} finger over the puncture. Then
exert gentle pressure above the puncture so that a small drop of blood
will exude into the fluid. Mix the two by passing the rod lightly
several times over the surface of the blended drop. (Some workers
first place a drop of the fluid upon the finger and then make the
puncture through it, this necessitating less care as to depth of the
puncture.) Now transfer a drop of the diluted blood from the finger to
a watch-glass which contains two or three drops of the fluid, and mix
well. From this, transfer a drop to the counting slide of the
Thoma-Zeiss hemocytometer, and cover. An ordinary thin cover will
answer for this purpose, and is preferable because it allows the use
of a higher power objective. Allow the slide to stand for at least
five minutes, and then with a one-sixth or higher objective count the
plaques and the red corpuscles in a definite number of squares. At
least 100 plaques must be counted. The number of red corpuscles per
cubic millimeter of blood having been previously ascertained in the
usual manner (p. 152), the number of plaques can easily be calculated
by the following equation:
_r_:_p_ :: _R_:_P_; and _P_ = _p_ x _R_/_r_.
_r_ represents the number of red corpuscles in any given number of
squares; _p_, the number of plaques in the same squares; _R_, the
total number of red corpuscles per c.mm. of blood; and _P_, the number
of plaques per c.mm.
Beginners are apt to take too much blood and not to dilute it enough.
Best results are attained when there are only one or two plaques in a
small square. With insufficient dilution, the platelets are more or
less obscured by the red cells.
The following diluting and fixing fluid is recommended:
Formalin 10 c.c.
1 per cent. aqueous solution sodium chlorid 150 c.c.
(Color with methyl-violet if desired.)
{168} This fluid is cheap and easily prepared, and keeps indefinitely.
It fixes the plaques quickly without clumping, and does not clump nor
decolorize the reds. It has a low specific gravity, and hence allows
the plaques to settle upon the ruled area along with the reds. Fluids
of high specific gravity cause the plaques to float so that they do
not appear in the same plane with the reds and the ruled lines.
* * * * *
VI. STUDY OF STAINED BLOOD
A. MAKING AND STAINING BLOOD-FILMS
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