22 The Microscope. 



pace witli the latest advances in his art to make himself familiar 

 with practical bacteriology. As there "were physicians thirty or 

 forty years ago who would not take advantage of the benefits of 

 physical examinations, so today many, satisfied with their present 

 methods, will pass over the positive information which an examina- 

 tion for micro-organisms will give. Not all physicians, however, 

 who are fully conversant with and wish to take advantage of the 

 best resources of modern medicine are able to devote the time that 

 is necessary to acquire dexterity in the technique of bacteria stain- 

 ing. Others again do not wish to purchase the somewhat costly- 

 apparatus that is requisite. To these the various microscopic labora- 

 tories throughoiit the country offer their aid. Many of the specific 

 diseases have been proven to be due to micro-organisms and it will 

 not be long before the pathogenic bacteria of them all will be dis- 

 covered. In at least four of these diseases, anthrax, relapsing fever, 

 tuberculosis and cholera, the diagnostic value of the finding of their 

 characteristic bacteria is of prime importance. The first two of 

 these diseases are not very common in our countiy and many of our 

 physicians are unfamiliar with their clinical histories, and this fact 

 enhances the value of a positive diagnostic sign. 



Too much cannot be said of the importance of a search for 

 tubercle bacilli in suspected tuberculosis. The unity of the variou.s 

 forms of phthisis is now definitely settled — they are but clinical 

 varieties of tuberculosis. " If, now, we discover in the sputum that 

 parasite, which we know to produce tuberculosis, we are forced to 

 conclude that a tubercular process is going on somewhere in the 

 respiratory apparatus, including the mucous membrane of the mouth 

 and pharynx." (Friedlander.) Tubercle bacilli are found in great 

 abundance on every point of tuberculous ulceration, however small, 

 and may often be demonstrated weeks or months before a positive 

 opinion can be formed of the nature of a suspicious apex-catarrh. 

 Can the physician afford to neglect such a valuable aid to diagnosis 

 and guide to treatment? The finding of bacilli although of grave 

 significance cannot be regarded as a positive indication that the 

 result will be fatal. Their discovery reveals the powerful enemy we 

 have to fight and shows the necessity of strengthening our defenses 

 against further invasions. It is general, not local, tuberculosis that 

 generally kills. A tuberculous spot may exist for years without imme- 

 diately compromising the patient's life, and so long as the disease 

 is localized we may hope that its progress may be checked; indeed, 

 post-mortem examinations show that fully fifty per cent, of the bodies 



