DIPHTHERIA 41 



the cork is pushed home into the tube as soon as it is cold 

 enough to handle. These swabs will keep indefinitely, and a 

 stock of them should always be kept at hand, as they are very 

 handy for other purposes. After use the cotton-wool should 

 be burnt off in a Bunsen burner or spirit-lamp, and another 

 piece applied and the whole resterilized. 



If a practitioner should see a supposed case of diphtheria 

 when he is unprovided with a swab he can readily extemporize 

 one which will answer sufficiently well out of some cotton- 

 wool (non-medicated), a wooden skewer or pen-holder, and a 

 glass phial. The wool is wrapped round the tip of the skewer, 

 and (after the swab has been taken) the latter is placed in the 

 phial in such a position that the cotton-wool does not touch 

 the glass; the place between the skewer and the neck of the 

 bottle is plugged with cotton-wool. It is not absolutely neces- 

 sary to sterilize the swab, although it is a very great advantage 

 to do so if time permits. 



The method of taking the swab is of great importance, and 

 must be carried out in full detail. It is necessary that the 

 patient should not have had an antiseptic gargle or application 

 for at least two hours previously. It is also advisable to allow 

 him to drink some beef-tea or boiled water (not milk, for this 

 may contain certain bacilli which closely resemble those of 

 diphtheria) immediately before the process. This will serve 

 to cleanse the parts. 



Requisites. I. A good light. 



2. The swab in its tube. 



3. A tongue depressor. The form which is hinged so as to 

 bend at a right angle is most convenient. 



4. A vessel containing antiseptic lotion or boiling water. 

 Method. i. Place the patient so as to face the light. If a 



small child, he should be held on his nurse's lap, with a blanket 

 wrapped round his chest so as to restrain his arms. 



2. Loosen the cork in the tube so that the swab may be 

 withdrawn with one hand, and place it at a convenient spot on 

 your right. If the child is old enough, you may give it to 

 him to hold. It may interest him and keep him quiet. 



3. Get the patient to open his mouth, insert the tongue 

 depressor (held in the left hand), and get a clear view of the 

 area chiefly affected. Do not proceed with the process (if it 

 can be avoided) until you have done this. 



