260 EXAMINATION OF SPUTUM. 



sterile water and should then be dropped into a tube of sterile bouillon. 

 With a sterile swab it should be emulsified and successive streaks made 

 along the surface of an agar or a glycerin agar plate. In obtaining 

 cultures from influenza sputum, first smear the material thoroughly 

 over a blood-serum slant; then inoculate, by thorough smearing over 

 the surface of successive blood-streaked agar slants, the material on 

 the surface of the blood- serum slant. The platinum loop should be 

 transferred from one slant to another without recharging. The in- 

 fluenza bacillus seems to grow better if the blood-streaked agar slants 

 are prepared just before inoculating with the sputum. All that is 

 necessary is to sterilize an ear, puncture and take up the exuding 

 blood with a large loop. Cultures for tubercle bacilli are impracti- 

 cable. A guinea-pig should be inoculated. 



The blood-stained watery sputum of plague pneumonia should be 

 cultured on plates of plain agar and 3% salt agar at the same time. 

 An ordinary smear stained with carbol thionin, however, practically 

 makes a diagnosis. 



Pneumococci, M. catarrhalis, and Friedlander's bacillus in sputum 

 are best demonstrated by Gram's method of staining. 



Moulds, especially Aspergilli, may be found in sputum. Species 

 of Mucor, Cryptococcus and Endomyces have also been reported. 



Amoebae from liver abscess rupturing into the lung may be found. 

 Very important pulmonary infections are those with Paragonimus 

 westermani. This is recognized by the presence of operculated eggs in 

 the sputum. 



Hydatid cysts, either of the lung or of the liver, rupturing into the 

 lung, may be recognized by the presence of echinococcus hooklets. 

 The material is bile-stained if from the liver. 



