A practical treatise on medical diagnosis for students and physicians / by John H. Musser.

  • Musser, John Herr, 1856-1912.
Date:
1904
Catalogue details

Licence: Public Domain Mark

Credit: A practical treatise on medical diagnosis for students and physicians / by John H. Musser. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    under these circumstances. In fact, the more rapid the bleeding the brighter the color of the blood. The hcemin test usually serves to dis- tinguish it. The suspected material is filtered and a little of the filtrate evaporated in a watch-glass; when dry, a small portion is mixed with finely pulverized salt upon a glass slide; it is then covered with a cover- slip underneath which one or two drops of glacial acetic acid are allowed to Sow. The acetic acid is evaporated by slowly heating the slip over a -mail flame, and when dry, a few drops of water are allowed to How under the cover-slip to dissolve the salt. If the vomit contains blood, brown rhombic crystals of hsemin (hsemin hydrochlorate) will appear under the microscope. As they are very small, a magnification of about •><><> diameters will he necessary to bring- them readily into view. This test is not always reliable J it is sometimes negative with stomach contents even when considerable quantities of blood are present. The guaiacum test may be fallacious, as the same color-reaction takes place when the test-liquid contains bile or saliva or a starchy substance like potato. It is performed as follows: add 2 or 3 drops of the tinct- ure of guaiacum to a small portion of the gastric contents in a test-tube and pour ozouic ether on the surface; when the liquids meet, a blue color develops. Bile may be distinguished from blood by tests for the former—color-reaction with iodine or nitric acid. If blood is present in the stomach contents, it may be detected by the test for iron. To the gastric contents, coffee-grounds, in a porcelain capsule, add a small quantity of potassium chlorate and a few drops of a strong acid, HC1. Heat over a flame and add a few drops of a 5 per cent, solution of potas- sium ferrocyanide. If iron is present, Prussian blue will be formed. Pus. Pus is rarely present in sufficient quantity to be detected by the naked eye, but it sometimes occurs in phlegmonous gastritis and when an abscess has ruptured into the stomach. Strauss states that pus-cells are never present in notable number except in cases of abscess communi- cating with the stomach and in ulcerating cancer. He considers their presence a valuable sign of cancer. Pus may be in the vomitus and yet come from the lungs. It is usually a muco-pus, and is recognized by the pigmented pellets or strings of mucopurulent material. Fecal matter is vomited in complete obstruction of the bowels and, according to Vierordt, in severe diffuse peritonitis. It is recognized partly by its appearance and partly by its odor. WORMS are sometimes vomited; the round worms not so very infre- quently ; oxyurides and ankylostomata rarely. Microscopical Examination. The illustration (Fig. 212) shows the various matters that may be found in vomited matter. Briefly, they are colum- nar and squamous epithelium ; white blood-corpuscles acted on by gastric juice; and red blood-corpuscles. The corpuscles are usually isolated. The red are rarely perfect, and in the white little more than the nucleus remains. From the food we may also find muscle-fibres, fatty globules, and fat-needles, elastic and connective-tissue fibres, starch-granules, and vegetable cells. Muscle-fibres are recognized by their transverse striation. Fat-globules are soluble in ether, and are recognized by their refracting power. Starch-granules stain blue with iodo-potassic iodide solution.