and Laboratory Methods. 



1653 



BACILLI WITH WHICH BACILLUS OF TUBERCULOSIS MAY BE CONFUSED. 



Bacillus of Leprosy, Bacillus of Syphilis (Lustgarten), Smegma Bacillus. 



Bacillus tuberculosis and these three bacilli, when stained with hot carbol 

 fuchsin, look very much alike. But by subsequent treatment they can be differ- 

 entiated. 



The so-called bacillus of syphilis is almost immediately decolorized in a five 

 per cent, solution of sulphuric acid in water. The smegma bacillus found under 

 the prepuce and on the vulva loses its color promptly in alcohol. Therefore to 

 differentiate, proceed as follows : Stain in hot carbol fuchsin- decolorize in five 

 per cent, sulphuric acid solution in water until the film appears free from color 

 to exclude the bacillus of syphilis, then wash in alcohol to exclude the smegma 

 bacillus. Red stained bacilli which may remain will be the bacilli of tuberculosis 



I'iG. I. Bacillus of Tuberculosis (Sputum). Stained I'lG. 11. Same as Fig. i. Magnification i2oodiame- 



wuth Carbol Fucli.sin and Gabbett's Blue. Magniti- ters as seen with 1-12" oil immersion, Zeiss projec- 



cation 800 diameters, Bausch & Lomb ]r" objective. tion ocular No. 4. 

 Zeiss projection ocular No. 4. 



or leprosy. The conditions and circumstances will ordinarily eliminate one or 

 the other. But if desired the differential diagnosis between them may be effected 

 by the following method : Stain another prepared cover in cold carbol fuchsin 

 six minutes, remove and decolorize in acid alcohol (nitric acid one part, alcohol 

 ten parts). By this method the bacillus of leprosy will be stained, the bacillus 

 of tuberculosis, the smegma bacillus, and the bacillus of syphilis will not be stained. 



METHOD OF EXAMINING CASES OF DIPHTHERIA. 



In all cases of sore throat the medical man should have in mind the possi- 

 bility of diphtheria, as occasionally a case of mild sore throat may be a diph- 

 theritic one and the contagion spread may become malignant. A microscopical 

 examination is therefore necessary early in every case. At this stage there are 

 so few of the Klebs-Loefifler bacilli present that the diagnosis cannot certainly be 

 determined from the microscopical examination when made direct from the 

 throat. In such suspected cases it is better to make a culture, and the physician 

 should have for this purpose sterilized apparatus ; but as it is not always possible 

 to have this, and improvised methods may be made to give good results. If nothing 

 else is at hand a pine stick with a little cotton wrapped on the end may be used 

 as a swab which should be rubbed against the infected part of the throat, usually 

 the tonsil. Rub rather hard so as to get some of the material on the cotton. 

 The stick may then be inserted in a test-tube or bottle with cotton wrapped 

 around it so as to make a stopper. This will enable the infected swab to be car- 

 ried home or to some bacteriologist's laboratory without drying. Rub the in- 

 fected swab on the surface of a prepared blood culture tube, which may be pur- 



