(1) Von Fleischl Method.—The apparatus consists of a stand somewhat like the base and stage of a microscope (Fig. 65). Under the stage is a movable bar of colored glass, shading from pale pink at one end to deep red at the other. The frame in which this bar is held is marked with a scale of hemoglobin percentages corresponding to the different shades of red. By means of a rack and pinion, the color-bar can be moved from end to end beneath a round opening in the center of the stage. A small metal cylinder, which has a glass bottom and which is divided vertically into two equal compartments, can be placed over the opening in the stage so that one of its compartments lies directly over the color-bar. Accompanying the instrument are a number of short capillary tubes in metal handles.

Having punctured the finger-tip or lobe of the ear as already described, wipe off the first drop of blood, and from the second fill one of the capillary tubes. Hold the tube horizontally, and touch its tip to the drop of blood, which will readily flow into it if it be clean and dry. Avoid getting any blood upon its outer surface. With a medicine-dropper, rinse the blood from the tube into one of the compartments of the cylinder, using distilled water, and mix well. Fill both compartments level full with distilled water, and place the cylinder over the opening in the stage so that the compartment which contains only water lies directly over the bar of colored glass.

In a dark room, with the light from a candle reflected up through the cylinder, move the color-bar along with a jerking motion until both compartments have the same depth of color. The number upon the scale corresponding to the portion of the color-bar which is now under the cylinder gives the percentage of hemoglobin. While comparing the two colors, place the instrument so that they will fall upon the right and left halves of the retina, rather than upon the upper and lower halves; and protect the eye from the light with a cylinder of paper or pasteboard. After use, clean the metal cylinder with water, and wash the capillary tube with water, alcohol, and ether, successively. Results with this instrument are accurate to within about 5 per cent.

A recent modification of the von Fleischl apparatus by Miescher gives an error which need not exceed 1 per cent. It is, however, better adapted to laboratory use than to the needs of the practitioner.

(2) The Sahli hemoglobinometer (Fig. 66) is an improved form of the well known Gowers instrument. It consists of a hermetically sealed comparison tube containing a 1 per cent. solution of acid hematin, a graduated test-tube of the same diameter, and a pipet of 20 c.mm. capacity. The two tubes are held in a black frame with a white ground-glass back.

FIG. 66.—Sahli's hemoglobinometer.

Place a few drops of decinormal hydrochloric acid solution in the graduated tube. Obtain a drop of blood and draw it into the pipet to the 20 c.mm. mark. Wipe off the tip of the pipet, blow its contents into the hydrochloric acid solution in the tube, and rinse well. In a few minutes the hemoglobin is changed to acid hematin. Place the two tubes in the compartments of the frame, and dilute the fluid with water drop by drop, mixing after each addition, until it has exactly the same color as the comparison tube. The graduation corresponding to the surface of the fluid then indicates the percentage of hemoglobin. Decinormal hydrochloric acid solution may be prepared with sufficient accuracy for this purpose by adding 15 c.c. of the concentrated acid to 985 c.c. distilled water. A little chloroform should be added as a preservative.

This method is very satisfactory in practice, and is accurate to within 5 per cent. The comparison tube is said to keep its color indefinitely, but, unfortunately, not all the instruments upon the market are well standardized.

(3) Dare's hemoglobinometer (Fig. 67) differs from the others in using undiluted blood. The blood is allowed to flow by capillarity into the slit between two small plates of glass. It is then placed in the instrument and compared with different portions of a circular disc of colored glass. The reading must be made quickly, before clotting takes place. This instrument is easy to use, and is one of the most accurate.

FIG. 67.—Dare's hemoglobinometer.