426 



Diphtheria 



be bought from almost any modern druggist. The swab is intro- 

 duced into the throat and applied to the false membrane, after 

 which it is carefully smeared over the surface of the blood-serum. 

 The tube thus inoculated is stood away in an incubating oven or 

 otherwise kept at the temperature of 37C. for twelve hours, then 

 examined. If the diphtheria bacillus be present, a smeary, creamy- 

 white layer with outlying colonies will be present. These colonies, 

 if found by microscopic examination to be made up of diphtheria 



bacilli, will confirm the diag- 

 nosis of diphtheria. There 

 are very few other bacilli 

 that grow so rapidly upon 

 LofHer's mixture, and 

 scarcely any other is found 

 in the throat. 



When no tubes of the 

 blood-serum mixture are at 

 hand, the swab can be re- 

 turned to its tube after hav- 

 ing been wiped over the 

 throat of the patient, and can 

 be shipped to the nearest 

 laboratory. 



When an early diagnosis 

 is required, Ohlmacher rec- 

 ommends that the micro- 

 scopic examination of the 

 still invisible growth be made 

 in five hours. A platinum 

 loop is rubbed over the in- 

 oculated surface; the small 

 amount of material thus se- 

 cured is mixed with distilled 

 water, spread on a cover- 

 glass, dried, fixed, stained 

 with methylene blue, and ex- 

 amined. An abundance of 

 the organisms is usually found and valuable time is saved pre- 

 paratory to the use of the antitoxin. 



Diphtheria Antitoxin. Behring* discovered that the blood of 

 animals rendered immune against diphtheria by inoculation, first 

 with attenuated and then with virulent organisms, contained a 

 neutralizing substance (Anti-korper) capable of annulling the effects 

 of the bacilli or the toxin when simultaneously or subsequently 

 inoculated into susceptible animals. This substance, held in solu- 



*" Deutsche med. Wochenschrift," 1890, Nos. 49 and 50; "Zeitschrift fiir 

 Hygiene," 1892, xn, i. 



Fig. 159. The Providence Health De- 

 partment outfit for diphtheria diagnosis, 

 consisting of a pasteboard box containing 

 a swab-tube and a serum-tube, both with 

 etched surface on which to write the name 

 and address of patients, etc. 



