File:Medical diagnosis for the student and practitioner (1922) (14597718420).jpg

Identifier: medicaldiagnosi00gree (find matches)
Title: Medical diagnosis for the student and practitioner
Year: 1922 (1920s)
Authors: Greene, Charles Lyman, 1862-
Subjects: Diagnosis
Publisher: Philadelphia, Blakiston
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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ay appear as mere shadowy circles and as such are easilyoverlooked. Crenation of the normal cells mav also occur in a urine that is THE EXAMINATION OF THE URINE 235 deficient in salt. Such cells have irregular, star-like processes along theirborder, but retain the yellow tinge of the normal cell. (//) Pus.—Pus in quantity is in most cases easily detected by the chemictest. The pus cell as seen under the microscope is identical with the whitecell seen in a smear preparation of normal blood but is less easily recognizedas such in the urine. /;/ the acid urine the pus cells are usually larger than the red cells, are color- Differentia-less, granular and, as a rule, in fresh specimens, their nuclei may be readilydistinguished by careful focusing. The presence of these nuclei serves to distinguish them positively from thered cells and any doubt upon this point may be readily removed by allowing ;a drop of very dilute solution of acetic acid to run beneath the cover-glass, maneuver. tion.
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Fig. 76.—Tyrosin. assisting the process, if necessary, by laying the edge of a piece of filter orblotting paper against the opposite edge. The acetic acid dissolves thegranules and brings out clearly the cell nuclei, but unless very dilute, willdestroy any hyaline casts that may be present. In ammoniacal urine, the puscorpuscles are soon destroyed, becoming agglutinated and losing their structuralcharacteristics. This maneuver is also useful in differentiating the leucocytes from renal cells.Varying Significance of Pus in the Urine.—As to the significance of pus! Diagnosticin the urine, it may be remembered that: (a) Pus that comes with the first jet of urine, the remainder being clear, isfrom the urethra. (b) A moderate amount of pus, appearing in an acid urine, is usually fromthe renal pelvis, but may be due to tuberculosis of the bladder. 236 MEDICAL DIAGNOSIS (c) Large quantities of greenish pus point to rupture of an abscess* in theurinary passages or to a pyelonephrosis. (d)

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