120 CLINICAL BACTERIOLOGY AND 



A sterile catheter is passed into the bladder, and, after 

 allowing a small proportion of the urine to flow away, the 

 remainder should be collected in a sterile jar and sealed 

 for examination. 



The urine thus collected is centrifugalized, and the 

 resultant deposit examined after removal of the supernatant 

 fluid by pipette or pouring. 



A hanging-drop preparation should be made of the 

 sediment and carefully examined under a \ and -jV oil 

 immersion. One will be able thus to detect bacteria if 

 present, and note if they are motile, if single or in pairs, 

 or in chains or bundles, etc. Films should now be made 

 in the ordinary manner and stained. If any difficulty 

 is encountered in fixing the film upon the slide, a drop 

 of one's own blood from a finger-prick and well mixed 

 with the urine will supply sufficient albumin to the field 

 to fix the specimen when heat or other fixing agents are 

 applied. 



When a culture is desired, the collection of the urine 

 and the inoculation of culture media requires the most 

 careful application to prevent risk of outside contamination. 



Where the kidneys are extensively invaded by bacteria, 

 the process of functional elimination in these organs 

 decreases, and with destructive changes going on in the 

 organs themselves, bacteria and tissue cells are continually 

 passing along the urinary tract. Rome of these pathogenic 

 organisms settle in the mucosa, causing cystitis and 

 urethritis; others are expelled with the urine; and super- 

 added in advanced cases one sees typical urasmic symptoms. 

 Drugs in such cases give little relief, although alkalies, 

 urotropin, and the volatile oils, may give temporary 

 benefits. 



Having ascertained the causative bacteria, a suitable 

 vaccine should be made in the usual manner, and the 

 phenomena carefully watched. 



If urasmia has already set in, much assistance can be 

 given to Nature by lowering the blood-pressure and stimu- 



