224 THE AMERICAN MONTHLY [July 



ment of mixed infection with diphtheria and streptococcus 

 bacilli by rendering- animals first immune against diphthe- 

 ria and thenag-ainst the streptococcus bacillus. The serum 

 prepared from the blood of such animals will, he expects, 

 serve to render the patient who is treated with it immune 

 to both the bacilli. 



MICROSCOPICAL MANIPULATION. 



The Microscopic Diagnosis of Trachoma. — Snydacker 

 (Medicine, Apr., 1899) states that the classification of tra- 

 choma has hitherto been so loose and uncertain as to ren- 

 der definite lines uncertain. Any form of follicular in- 

 flammation of the conjunctiva which resisted treatment 

 and persisted for any leng-th of time has been regarded a 

 form of the disease. Snydacker claims the etiologic factor 

 of trachoma is constant, and its recog-nition only assures 

 us of an accurate, certain and scientific diag-nosis. In this 

 view, he is not supported as yet, althoug^h his previous 

 paper is receiving- marked attention. According- to Sny- 

 dacker, trachoma is due to a capsulated diplococcus, 1>^ to 

 2 microns in leng-th and 5 microns in breadth, which is not 

 decolorized by the Gram method of staining-, and whose 

 septum at times has an affinity for anilin stain, causing- the 

 diplococcus to simulate a bacillus. The org-anism is con- 

 stantly present in the trachoma follicle and secretions, be- 

 fore astring-ent and antiseptic remedies have been employ- 

 ed. It is easily differentiated from all other g-erms, as none 

 other answers to its description. The method employed 

 in suspected cases of trachoma is briefly as follows : When 

 enlarg-ed follicles are found, one of these is expressed and 

 its contents employed. If there are no follicles, the secre- 

 tions cm be examined, thoug-h these are very unsatisfac- 

 tory. The expressed follicular contents are spread thinly 

 and evenly over four cover-glasses ; two of these are fixed 

 ten minutes in absolute alcohol, two are fixed in a flame. 

 One of each kind is now put throug-h the ordinary Gram 

 method of staining-. The other two are stained according- 

 to the Gram-Weig-ert method, lithium carmine being- em- 



