Clinical diagnosis : the bacteriological, chemical, and microscopical evidence of disease / by Rudolf v. Jaksch ; translated from the second German edition by James Cagney ; with an appendix by Wm. Stirling.

  • Cagney James.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Clinical diagnosis : the bacteriological, chemical, and microscopical evidence of disease / by Rudolf v. Jaksch ; translated from the second German edition by James Cagney ; with an appendix by Wm. Stirling. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    35/432 (page 7)
    tion may occur as a consequence of liaeinorrlmge, whether of a traumatic origin, or due to morbid changes in the blood-vessels, as when intestinal bleeding takes place in typhoid fever. As a permanent state, it may be a phenomenon of any disease which is attended with deficient re- ceneration of the blood. [The number of the red corpuscles is lessened in chronic lead- poisoning, miasmatic conditions, and in syphilis.] Diagnosis of Oligocythmmia.—The methods and apparatus employed by physiologists to estimate a diminution of the red blood-corpuscles are very many ; but of these a large number are useless for clinical purposes, inasmuch as they require too great quantities of blood to work upon. The apparatus which will serve our purpose is of two classes. One is used to count the actual number of blood-corpuscles in a specimen of blood; the other, by estimating the quantity of haemoglobin present, enables us to draw an inference as to changes in the blood. Both methods have their advantages and supplement each other, since a diminution in the haemoglobin is usually proportionate to a diminu- tion in the red corpuscles; thus, oligochromssmia and oUgocijtheemia mostly occur together. When the oligocythsemia is very pronounced, a glance through the microscope will suffice to recognise it; and so with oligochromae.mia— diminution of haemoglobin—a little practice will enable us to detect it by a simple examination of the blood in a very thin layer without the addition of any fluid. To effect this, the end of the finger should be washed in plain water, and pricked, and the first drops of blood allowed to flow off. A glass slide should then be allowed to touch the summit of the drop of blood on the skin without coming in contact with the finger, quickly withdrawn, and a cover-glass placed over it. In this way such impurities as epithelium, &c., are avoided. The use of carbolic acid, sether, or alcohol, to wash the skin, is not to be recommended, since these bodies are likely to produce changes in the appearance of the corpuscles. When the object of the examination is the detection of micro- organisms in the blood, the utmost care must be taken in cleansing the skin (see p. 27). Proceeding in this way in a case of oligocythaemin, when the slide is placed under the microscope, a marked diminution in the number of blood-corpuscles will be noticed. The red corpuscles will also in most cases be paler than norm.al; their usual bi-concave shape less marked; they are .somewhat flattened, and they tend less to run into rouleaux or assume stellate forms. At the same time, they may be seen to have undergone peculiar changes of shape {poilcilociitosis). For many purposes it is well to fix the blood with some preserving