120 THE AMERICAN MONTHLY [April 



The Microscopical and Cliemical Aids to Diagnosis. 



By Dr. KATHRINE K. COLLINS. 

 On October 14tli, 1896, before the Tristate Medical 

 Society at Cliattaiiooga, Dr. Kathrine R. Oollina read a 

 paper on ".Microscopical and < 'liemical Aids to Diagnosis." 

 The writer takes the position that by these two means 

 yaluable assistance to diagnosis maybe obtained, but at 

 present it is, too often, the case that these examinations 

 are hurriedly and carelessly made thus bringing about 

 very unsatisfactory results. The examination of one 

 specimen of urine being frequently considered all that 

 is necessary, not as the abnormal constituents of the 

 urine mav occur without any coe.xisting pathological con- 

 dition, as the presence of sugar or albumen after a meal 

 rich in these substances, the one examination is without 

 value. Also in the microscopi* al work many conditions 

 may be overlooked in the single examination or the pres- 

 ence of the tubercle bacilli in the sputum of tuberculous 

 patients. Attention is then called to some of the diflB- 

 culties interfering with the tests for sugar in the urine; 

 the value of estimating the amount of chlorides excreted 

 in pneumonia ; the presence and value of the Drazo-re- 

 action in typhoid fever, pulmonary tuberculosis, puer- 

 peral conditions and concealed septic processes, the pro- 

 gress of structural diseases of the kidney being marked 

 by the amount of urea present, a diminution, showing 

 non-elimination and consecjumt absorption. 



In the examinations of the sputum, the Lurshman-Ley- 

 den spirals in bronchial affections, the Charcol-Leyden 

 crystals in bronchial asthma, the elastic fibres and the 

 tubercle bacillus. The ])resence of the Klebs-Loeffler 

 bacillus of diphtheria should be demonstrated in every 

 case of that disease, as it will lead to a sharper line be- 

 ing drawn between true diphtheria and these throat 

 aflfections that simulate the disease. The pneumococcus 



