EAR SMEARS 



110 



EHRLICH'S TRIACID 



rare . House , H . P . (Ann . Otol . , Rhinol . 

 and Laryngol., 1949, 58, 789-797) re- 

 viewed the literature and reported that 

 201 authentic cases of the disease have 

 been reported. He discussed two cases 

 in which the technique of Papanicolaou 

 aided in diagnosis and indicated, that 

 since the majority of malignancies of 

 the middle ear are superimposed on 

 chronically discharging ears, the method 

 should prove of value in the early 

 diagnosis of carcinoma of the middle 

 ear. Diamont, M. (Acta Otolaryng., 

 1941, 29, 77-79) pointed out the diffi- 

 culty even with the Papanicolaou stain 

 of differentiating clinically between 

 granulations in chronic otitis and early 

 malignancy. Smears, however are very 

 useful in these cases in efforts to follow 

 the cytology of the lesions after opera- 

 tive procedures. Subsequent biopsies 

 are not always feasible. The smear 

 technique causes no inconvenience to 

 the patient. It is reliable in the evalua- 

 tion of x-ray and radium therapy since 

 the effects of such treatments are re- 

 flected in the cellular response. 



It seems important, in order to ob- 

 serve all of the cellular details possible, 

 to use the method of Papanicolaou as 

 well as a good polychrome stain, such 

 as Wright's or Hansel's, especially in 

 the chronic ear conditions, so that the 

 exudate can be studied in both stains. 

 Details of the light staining with 

 Wright's and of the use of buffer solu- 

 tion are described in the staining of 

 Nasal Smears. Short drying of the 

 slide in air, rather than flaming, is 

 recommended for maximum cellular de- 

 tail. Whenever possible, in order to 

 complete the cytological picture, it is 

 interesting to use the supra-vital tech- 

 nique on living fresh material. There 

 are vast differences in appearance be- 

 tween living and stained cells so that 

 accurate cellular differentiation be- 

 comes a complicated problem. In order 

 to insure good results from any of the 

 staining techniques, a fresh sampling 

 of the discharge is imporatnt. It has 

 often been found satisfactory to use a 

 frontal sinus silver cannula with rubber 

 bulb to obtain the secretion as close as 

 possible to the point of perforation of 

 the drum membrane. The discharge 

 may then be released and spread evenly 

 and thinly on a clean glass slide. At 

 mj^ringotomy it is taken directly follow- 

 ing the incision of the drum membrane. 



Since there are a number of reliable 

 staining methods that are adaptable 

 to the study of aural exudates, the 

 knowledge gained thereby can be cor- 

 related with the clinical symptoms of 



the patient. This laboratory aid is 

 important in otologic examination and 

 stimulates an awareness of the ever 

 changing pathological processes. 



Earle, see Tissue Culture. 



Ectoplasm. Cytoplasm lying immediately 

 internal to the plasma membrane. It 

 is usually gelled, and, being free from 

 various formed bodies present in the 

 endoplasm, has a clear hyaline appear- 

 ance. 



Egg, inoculation of hen's eggs, see Chorio- 

 allantoic Membrane. Egg of hel- 

 minths, see Floatation Techniques. 

 Transplantation of living fertilized 

 eggs, see account of Placenta. 



Ehrllch-Biondi Stain, known also as the 

 Ehrlich-Biondi-Heidenhain mixture, is 

 one of the classical stains. 



Add 20 cc. sat. aq. acid fuchsin and 50 

 cc. sat. aq. methyl green to 100 cc. sat. 

 aq. orange G agitating the fluid while 

 doing so. Add 60-100 cc. aq. dest. The 

 diluted mixture should redden slightly 

 if a little acetic acid is added. A drop 

 placed on filter paper should be bluish 

 green at the center and orange at the 

 periphery. If there is an outside red 

 zone too much fuchsin has been used. 

 Stain sections of sublimate fixed tissues 

 12-24 hrs. Do not wash in water but 

 dehydrate quickly. Clear and mount. 

 This stain gives beautiful results when 

 properly employed but it is fickle. 

 Many helpful suggestions are given in 

 Lee, p. 179. 



Ehrlich's Acid Hematoxylin. Dissolve 2 

 gm. hematoxylin in 100 cc. 95% alcohol 

 and add; aq. dest., 100 c; glycerin, 100 

 cc; ammonium (or potassium) alum, 3 

 gm., glacial acetic acid, 10 cc. Ripen 

 by exposure to air (but not dust) 2 or 

 3 weeks, or immediately by addition of 

 0.4 gm. sodium iodate. 



Ehrlich's Aldehyde Reagent. 2 gms. para- 

 dimethj^lamino-benzaldehyde in 100 cc. 

 20% aq. hydrochloric acid. See Uro- 

 bilin. 



Ehrlich's Triacid blood stain. This, also, 

 is one of the classic stains, now seldom 

 used. It contains methyl green, orange 

 G and acid fuchsin; but methyl green 

 is a basic dye so that it is not made up of 

 three acid dyes. Ehrlich explained that 

 it is so called "because in it all the three 

 basic groups of the methyl green are 

 combined with acid dye-stuffs" (Lee, 

 p. 167) with which modern chemists do 

 not agree. Air dried smears are fixed 

 by heat (110°C) about 2 min.; stained 

 in triacid (Griibler) 5 min. ; washed in 

 aq. dest. until no more color is extracted 

 and dried with smooth filter paper. 

 Said to color neutrophile granules and 

 leave azur granules unstained. 



