GREY RIVER HOSPITAL

Grey River Argus, 22 March 1928, Page 2

GREY RIVER HOSPITAL

THE LABORATORY Interesting Installation Probably only a comparatively few of the people entering a modern hospital form an intelligent conception of the manifold processes, tests, and researches which make up the technique of their treatment. There survives in many minds the almost medieval idea i of doctors relying almost entirely upon intuition when judging what is the matter with the sufferer, and likewise when devising or concocting a remedy. As a matter of fact, one of the great medical developments of modern times has been to substitute objective tests for what might have seemed guesswork in the old sphere of medical practice. No doubt, the genius of surgeon or physician is now no more dispensable—for all the bacteriological lore that has emanated from Louis Pasteur, or the antiseptic discoveries of Lord Lister—than it was in the old days of the blood-letters and bone-setters; but it is certain that genius is vastly aided and strengthened in our own time by the wonderful data obtainable by the aid of mechanical agents, :tnd especially the guidance provided by criteria supplied from an up to date Laboratory. There is an illustration locally, at the Grey River Hospital, where the recent provision of a Laboratory has greatly facilitated the courses of I reatment necessary for a wide range

of cases, some of ailments very common, and others quite singular in character. By the. aid of the laboratory apparatus, it is possible to gauge the internal state of patients just as accurately in many respects as if the knife were applied to reach the organs under scrutiny. The Greymouth Laboratory, which is under the charge of Sister Braidwood, who underwent her training for the work at Christchurch, docs duty at present for all of the West (’oast Hospitals, and for the lay person it is scarcely less interesting than it is for the cognoscenti of the medical profession. It is divided into two sections —the chemical and the bacteriological—and is ranged around with a st range-looking collection of articles

and contrivances, and with equally unfamiliar substances of unsuspected uses. One of the first things to catch the eve is a machine resembling the inter-

nal mechanism of a cream separator. As a matter of fact, it is exactly a separator, but its subject matter is not the lacteal fluid which the healthy bovine family supply, but quite other liquids and semi-liquids emanating from the human species and usually where its members are not in a condition that is healthy. The process, however, is similar. The apparatus is called a Centrifuge, and is electrically There is a perpendicular shaft, to the top of which are attached containers, radiating like wheel spokes, and into these glass tubes are placed, containing the substances of which the liquid components are to be separated from the solid contents. Thus some human blood may be placed in one tube, urine in another tube, and any other derivative from the human organism in a third tube. The electric current is then applied, the shaft begins to turn at so many hundred revolutions per minute, ami the action of the separator is in progress. Just as the centrifugal force separates the fat particles from the other elements of the milk within the cream separator, so the same force in the Centrifuge forces apart the solids ami liquids in the tubes, and after a brief interval the tube containing blood r veals at the bottom solid matter and almost colourless liquid at the top. The analysis of the blood is thereby facilitated, and the agent in the process has been purely mechanical. The oldtime Centrifuge was hand-turned, and the work occupied a very much longer time, and called for a tiresome expenditure of energy.

In the chemical section there is the Aeration Apparatus, used for estimating the quality of urine, and consisting of a series of long pipes of glass, connecting tubes of the same material. The essential element in urine is urea, n soluble, crystalline body, similar to ammonia. This is an agent which sets up disease in the body when the kidney# fail to filter it from the blood. The Laboratory expert has at hand in a vessel a specimen of urine, artificially compounded, but corresponding to the healthy discharge, which is used as a standard for comparison; and the condition of the patient is determined in this respect, by ascertaining whether there is excess or deficiency of the essential constituent, urea. Glass, of

Il Laboratory, there being a scries of very long, delicate vessels for measuring liquids, graduated so that almost infinitesimal quantities may readily be gauged. This equipment is very costly, the glass requiring to he specially tempered, and most accurately marked, while many of the glass tubes are subjected to high temperatures. These vessels have to he procured abroad, in Germany, America, or Scotland, not being purchasable in the Dominion. Turning to the bacteriological section of the Laboratory, one sees an assemblage of articles which look quite innocent, but which contain vast multitudes of the deadly germs of infectious and contagious disease. First is an electric oven, in which the tubes, swabs, and other objects used in cultivating the bacteria are sterilised. There are, in fact, a couple of sterilisers, one heated electrically, and the other heated by steam. Into these cleansers the tubes, etc, are placed, and the heat kills all bacterial life there may be about them. Phials, tubes, and other glass containers arc used for the bacilli or germs, wither of bacteria, typhoid, scarlet fever, tuberculosis, or other diseases. These often arc obtained from the patient when they are in the embryonic stage, and require to be developed, with their appropriate food, and habitat, coinciding in temperature with their native environment in the human body. Means for this process are all at hand. One particular class of germs dealt with are the food poisoning groups of bacteria, chiefly obtained from the stomach and the intestines. Within the sterilised glass tubes, the operator places

specially prepared serum, wherein to culture the germs. The serum is in the form of a thin fluid obtained from a bullock’s heart, and is given three cookings, for one hour at a time, on successive days. In the Laboratory kitchen there are the cooking utensils. Under the influence of heat the serum is first extracted and filtered through a sheet of material like tissue paper, and after the cooking process the baccili are placed in this element, broth being also used to feed them. Gazing upon a large colony of diphtheria germs in a tube, one’s imagination fails to conjure up any representation of their ravages upon the human throat, but the fact remains that the greyish little mass., not unlike molten tallow, would be sufficient to send many to their doom. There is an electric water bath for regulating the temperature of the media, and also an incubator, a remarkable affair, which maintains within a unifornj temperature (about the same as that of human blood) no matter what may be the temperature outside of it. It is heated by electricity, but at the local Laboratory a paraffin lamp is occasionally used with equal effect. Seeing a culture of germs going first into this incubator, one might doubt the existence of any life whatever in the gelatinous mass; but a glance at another culture which lias had a day’s incubation reveals a transformation that is really surprising. Some of these cultures are of germs that poison food after it is eaten, the existence of which sufferers seldom suspect in their interior. On a shelf stands a jar containing a floury looking substance. which proves to be pulverised seaweed from Japan, named “AgarAgar,” and the Bacteriologist remarks that this substance is beloved by the bacteria that constitute diphtheria. Tiny, sealed glass vessels, kept in a cupboard, contain anti-toxins, or vaccines, the injection of which acts as an antidote for the corresponding diseases. Dead bacilli, to the number of perhaps twenty millions, are contained in a thiinblefull of these vaccines, such as that for nasal catarrh. Another specimen is an extract of hydatits, the injection of which reveals if the patient has the hydatid disease.

Another most fascinating side Df the Laboratory is that denoted by the Microscope. The instrument at the Grey River Hospital is one of the most up to date type, costing about £4O, and one of its several small Icnsse cost-

ing about £5. The objects with which it deals, bacteria and minute animal cells, are magnified by no fewer than eleven hundred times their normal size. A very interesting test which the operator conducts in a couple of minutes is that of the human blood. A prick with a needle draws a drop of blood from the thumb, and this is smeared over a small, flat square of glass, which is first dried over a spirit flame. The operator then pours a small quantity of dye over the smear of blood. The dye has the effect of staining and fixing the miscroscopic corpuscles. In a cubic centimetre of blood there are many millions of these minute animal cells, called corpuscles, and when magnified 1100 times one of them looks no larger than

a pin head. The deleterious white corpuscles take from the dye the colour of blue, and the red healthy corpuscles appear red. Without the dye, of course, they would lack in so thin a film any definite colour whatever. Oiiq test noted was that of a patient with a rare blood disease, and the proportion of white corpuscles was seen to be many times too great. Each blood cell stood out clearly under glass, and even those cells which evidently had different sections could be differentiated by the eye according to their structure. A test of normal blood revealed one, two or three white cells among hundreds of red ones. The- white ones in the diseased blood tested were stated by the Bacteriologist to be pus-discharging ones, and she also pointed out differences among the white corpuscles, and likewise among the red ones. The next, examination under the glass was one of diphtheria microbes, which are very much smaller than the blood cells, and which were revealed in clusters, like grapes. The dye used in their case gave them a reddish tint. For other bacilli, different dyes are required. The dyes, which all are manufactured in Germany, make the- structure of the organism appear quite distinct, as well as conferring on them a. colour which they naturally lack. Still other dyes are used for the food poisoning bacteria or those of tuberculosis. The light used in the microscope is electric. On top of the square of glass whereon the germs are fixed, cedarwood oil is dropped so as entirely to exclude the sun ’a rays, which arc a defective media for observation, while the electric rays are focussed with the aid of a small mirror. Normal healthy blood, indeed, may differ widely as between one and other individual, there being four groups, and the value of the classification is that it safeguards operations in which there is blood transfusion. For instance, those in the No. 4 class are what are called “universal donors,” whose blood may lie given to all others, whereas the blood of those in some of the other classes, if transfused into a person of a. different class, would cause death. Yet another function of the Laboratory is to test the condition of the human stomach, not for bacteria, but for aci- 1 dity. Records are kept, known as Test Meal Charts, on which arc graphed the varying degrees of acidity in the stomach during the whole process of digestion. The patient is fed a special meal, and by extracting the contents from the stomach and examining these in the Laboratory, the progress of digestion and variations of the digestive organs can be accurately ascertained. On the chart there are curves which show the acids rising to the maximum three hours or so after food has been taken, and the experts can tell from the nature of the curve whether the acidity is so groat as to prove the existence of an ulcer. In one chart there appeared almost a total absence of acid, so that the treatment indicated was to supply the missing element in the food or otherwise. In the former instance, a lessening of the acid supply in food was indicated as necessary. This phase has an interest for rheumatic sufferers, that ailment being due to defective acidity. A more glance over the processes going on at the Laboratory is sufficient to convince the average person of its wonderful worth and utility in the treatment of disease in very many forms. For instance, in a case of appendicitis, the microscope might

be the revealer of the need for an immediate operation, by the insight it gives into the state of the blood, and its demonstration of an abnormal content of whit ecorpuscles. Formerly, laboratory work for the West Coast had been done in hospitals at a distance, and the provision of the local installation is calculated to save not only suffering and worry, but doubtless not a few lives in the course of the years. Apart from that, it is for the lay per son a real revelation of the strides made during recent years in the science of medicine.