EXAMINATION FOR BACTERIA. 



the investigation of a drop of fluid drawn from the bubo 

 (if one is present) permits of an easier and earlier diag- 

 nosis. The blood examination is of most value in the 

 pulmonary and septicaemia forms of plague. 



10. The spirillum of relapsing fever is easily found, for 

 it possesses well marked characters and is present in 

 great numbers. The diagnosis of relapsing fever can- 

 not be made until it has been demonstrated. 



1 1 . The gonococcus has been found in the blood in a 

 few cases of ulcerative endocarditis. Its detection by 

 cultural methods is very difficult, and the services of 

 a bacteriological expert should be called in if the 

 characteristic cocci are not found in blood films in a 

 case in which the diagnosis of gonorrhceal ulcerative 

 endocarditis is probable, as further information upon 

 this point is greatly needed. We may point out that 

 ulcerative endocarditis, septicaemia, &c., supervening in 

 the course of an attack of gonorrhoea are not necessarily 

 due to the gonococcus. Any pathogenic bacteria may 

 enter through the lesion of the mucous membrane 

 which the gonococcus has caused. 



12. The bacillus coli is present in some cases of septi- 

 caemia. 



EXAMINATION FOR BACTERIA IN FILMS. 



This is the easiest method in which bacteria may be 

 found in the blood, and it does not require such a rigid 

 antiseptic technique as is necessary if cultures are to be 

 taken. The films are prepared and fixed in one or 

 other of the methods which we have described, the only 

 point worthy of notice being that the skin must be very 



