380 BACTERIOLOGY. 



Directions for Inoculating Culture Tubes with the Ex- 

 udate. The patient is placed in a good light, and, if a 

 child, properly held. The swab is removed from its 

 tube, and, while the tongue is depressed with a spoon, 

 is passed into the pharynx (if possible, without touch- 

 ing the tongue or other parts of the mouth) and is 

 rubbed gently but firmly against any visible membrane 

 on the tonsils or in the pharynx, and then, without 

 being laid down, the swab is immediately inserted in 

 the blood-serum tube, and the portion which has pre- 

 viously been in contact with the exudate is rubbed a 

 number of times back and forth over the whole sur- 

 face of the serum. This should be done thoroughly, 

 but it is to be gently done, so as not to break the sur- 

 face of the serum. The swab should then be placed 

 in its tube, and both tubes, thin cotton plugs having 

 been inserted, are reserved for examination or sent to 

 the laboratory or collecting station (as in New York 

 City). If sent to the health department laboratories 

 for examination the blank forms of report which usu- 

 ally accompany each "outfit" should be filled out and 

 forwarded with the tubes. 



Where there is no visible membrane (it may be 

 present in the nose or larynx) the swab should be 

 thoroughly rubbed over the mucous membrane of the 

 pharynx and tonsils, and in the nasal cavities, and a 

 culture made from these. In very young children care 

 should be taken not to use the swab when the throat 

 contains food or vomited matter, as then the bacterio- 

 logical examination is rendered more difficult. Under 

 no conditions should any attempt be made to collect 

 the material shortly after the application of strong 



