A surgical handbook : for the use of students, practitioners, house-surgeons, and dressers / by Francis M. Caird and Charles W. Cathcart.

Caird, Francis Mitchell, 1853-1926

Date:: 1889

Credit: A surgical handbook : for the use of students, practitioners, house-surgeons, and dressers / by Francis M. Caird and Charles W. Cathcart. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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$set aside without further l)()iHny. If no milkiness is produced ns the mixture cools, the urine may he conlidently pronounced free from sugar, for no cjuantily above a fortieth of a grain can escape such a search, and any quantity below that is devoid of clinical significance. ((•.) Bile.—A test for bile is equivalent to a test for bilc-pigmenls. Test for Bik-pignieiits.—Place a few drops of urine on a while- ])orcelain plate, and near it lay a few drops of nitric acid. Bring the two fluids in contact by inclining the plate, and if bile be ])resent, a play of colours will appear violet, green, red, whicii rapidly passes away. The Test for Bile Acids is less certain, and may be omitted. ((/.) Pus and Mucus.—Take any of the doubtful sediment, and treat with concentrated caustic potash; pus will become a tough uuico-gelatinous mass, while mucus will be changed into a thin Hocculent fluid. Examination of Deposits. — Before minutely examining any urinary deposit with the microscope, its naked eye characters should be carefully noted, as they alone are often distinctive. When the deposit after standing is small, and j'et where its microscopic examination is important, the clear urine at the top of such a jar should be decanted off, and the remainder poured into a conical glass. After a second decanting, some of the subsequent deposit may be removed with a pipette, and placed on a glass slide under a cover-glass. Sir Henry Thomson advocates the simple expedient of allowing the urine to stand in a corked Ijottle placed with the cork downwards. The deposit which afterwards adheres to the cork can be easily examined. For descriptive purposes deposits may be divided into two groups— I. Unorganised Substances (soluble in moderately strong solutions of either acids or alkalies). Such as amorphous urates or phosphates, crystals of uric and oxalic acids, or of triple phosphate, and, rarely, cystine. II. Organised Sulistances (more or less altered by weak acids or especially alkalies, but not dissolved by them).—Such as epithelial cells, pus, blood, or mucus, spermatozoa, tube-casts, •micro-organisms, and foreign particles, which have olitained access to the urine. For the examination of all these deposits, magnifying powers of 50 and 350 will be found sufficient. I. Unorganised Substances.—A. /;/ an Acid Urine.—(i) Urates form a loose deposit mingled with mucus, varying from a brick-red to a dirty yellow colour. They are distinguished from all other deposits (a) by being completely soluble by heat, (/3) by forming a film on both the surface of urine and on the sides of the vessel in which the urine has cooled {Roberts). They may be combined with other deposits. Under the microscope they are amorphous and granular. (2) Uric ..^crzfl'. —Insoluble in dilute acids, soluble in caustic alkalies, in weak solutions of carbonate of lithia, potash, or soda, and$