THE URINE 165 



They occur in profusion (often mixed with yeasts) in many 

 cases of simple dilatation of the stomach, though not in all. 

 They occur in other conditions, but are very rarely found in 

 cases of carcinoma, and this is the only importance attaching 

 to them. 



In dealing with cases of gastritis (whether acute or chronic) 

 due to infection with a single pathogenic organism the pos- 

 sibility of vaccine, treatment should be borne in mind. I ob- 

 tained excellent results in a case of chronic gastritis due to 

 the pneumococcus by means of a vaccine after ordinary 

 medicinal means had failed. Suitable cases are those in 

 which there is in the vomit or test-meal material pus or 

 muco-pus containing the org'anism in pure culture. Flakes of 

 the pus should be picked out from the fluid, thoroughly 

 washed in normal saline solution, and plate cultures (prefer- 

 ably tube-plates on agar) made. 



THE URINE 



The more important investigations in which the urine has 

 to be examined have been mentioned already. See p. 70 

 (tubercle bacilli) and p. 105 (gonococci). 



Methods. Where the examination is to be microscopical 

 and not cultural it is not usually necessary to use a catheter 

 specimen. The urine is to be passed directly into a sterilized 

 vessel (or at least a clean and dry one), the first portion being 

 passed into another vessel and rejected. 



In most cases it is not absolutely necessary to centrifugalize 

 the urine, since the bacteria are commonly present in large 

 numbers, but it is an advantage when this can be done. It is 

 not advisable to allow the urine to deposit spontaneously, as 

 there are many chances of accidental contamination, and many 

 common bacteria grow with great rapidity in urine. 



The examination should commence by the inspection of a 

 wet preparation between slide and cover-glass preparation, 

 first under the J, then under the T V- This will enable you to 

 recognize the presence of motile bacilli, streptococci, other 

 cocci, etc. ; pus, blood, epithelial cells, etc., and crystals. 



Then pass on to film preparations, preferably from the 

 centrifugalized deposit. Prepare films in the ordinary way 

 and stain by Gram, counterstaining by dilute carbol fuchsin. 



