Staining 717 



Pappenheim,* having found bacilli stained red by Ziehls' 

 method in the sputum of a case which subsequent post- 

 mortem examination showed to be one of gangrene of the 

 lung without tuberculosis, condemns that method as not 

 being sufficiently differential, and recommends the following 

 as superior to methods in which the mineral acids are em- 

 ployed : 



1. Spread the film as usual. 



2. Stain with carbol-fuchsin, heating to the point of steaming for a 



few minutes. 



3. Pour off the carbol-fuchsin and without washing 



4. Dip the spread from three to five times in the following solution, 



allowing it to run off slowly after each immersion: 



Corallin i 



Absolute alcohol 100 



Methylene-blue . ad sat. 



Glycerin 20 



5. Wash quickly in water. 



6. Dry. 



7. Mount. 



The entire process takes about three minutes. The tubercle 

 bacilli alone remain red. 



Where examination by this means fails to reveal the 

 presence of bacilli because of the small number in which they 

 occur, recourse may be had to the use of caustic potash or, 

 what is better, antiformin (q. v.) for digesting the sputum. 

 A considerable quantity of sputum is collected, receives the 

 addition of an equal volume of the antiformin, is permitted 

 to stand until the formed elements and pus-corpuscles have 

 been dissolved, is then shaken and poured into centrifuge 

 tubes and whirled for fifteen to thirty minutes. The sedi- 

 ment at the bottom of the tubes will then reveal the bacilli 

 which, having been freed from the viscid materials in the 

 sputum, have been thrown down by the centrifuge. When 

 the number is still smaller, it may be possible to show their 

 presence by guinea-pig inoculation though staining methods 

 all fail. 



The possible relation that the number of bacilli in the 

 expectoration of consumptives might bear to the progress 

 of the disease was investigated by Nuttall.f 



But a glance down the columns of figures in the original 

 article is sufficient to show that the number of bacilli is devoid 



*"Berl. klin. Wochenschrift," 1898, No. 37, p. 809. 



f "Bull, of the Johns Hopkins Hospital," May and June, 1891, n, 13. 



