THE MICROSCOPE IN DIAGNOSIS. 319 



hsemorrhoids, fistula, etc., while more disintegrated disks 

 indicate effusion further up the intestinal tube. 



Mucous casts or coagula of albuminous matters are not 

 very uncommon, either in flakes or tubular casts. The 

 mucus entangles epithelial cells, usually from the large 

 intestine. In typhoid fever crystals of triple phosphates, 

 altered blood, bacteria, and various fungi may be found 

 in the faeces, and the stools of cholera patients contain 

 large quantities of cylindrical epithelium, so that the 

 white flocculi are almost entirely composed of it. 



Elastic fibres, exhibiting transverse striae like those of 

 the ligamentum nuchse of the giraffe, are sometimes found 

 arising, in all probability, from incipient decomposition 

 of ingesta. 



Larvae of insects may sometimes be passed alive from 

 the bowels, as well as be ejected from the stomach. The 

 various forms of intestinal worms in their various stages 

 of development may also be met with. In some instances 

 the microscope is needed to distinguish between suspected 

 worms, or portions of worms, and accidental products. 

 Fatty matter in the stools, sometimes semisolid, is usually 

 attributed to derangement of the pancreas. 



VIII. VAGINAL DISCHARGES. 



The diagnostic value of discharges from the vagina, 

 either uterine or vaginal in their origin, has been yet but 

 little studied, and presents a field of special interest in 

 gynaecology. The discharge should be examined while 

 fresh and without the addition of water or other fluids if 

 possible. Should fluid menstrua be really necessary, in- 

 different fluids only should be used. 



The menstrual discharge will be likely to contain young 

 and old epithelial scales and blood-globules. In dysrnenor- 

 rhoea considerable patches of the epithelial membrane 

 desquamate, and even entire casts of the uterus or vagina 



