DIPHTHERIA 47 



many Gram-positive bacilli other than those of diphtheria to 

 be met with in inflamed throats.* 



An additional method of staining- may be of value. 



Neisser's method : Use an 18 hour culture on blood-serum, 

 or films prepared direct from the membrane or swab. Pre- 

 pare films in the usual way, fix, and stain for one minute in. 



Methylene blue I gramme 



Alcohol (96 per cent.) 20 c.c. 



Glacial acetic acid ... ... ... 50 c.c. 



Water 950 c.c. 



Wash and counterstain one minute with 



Bismarck brown (vesuvian) ... 5 grammes 

 Water 1000 c.c. 



Diphtheria bacilli frequently contain polar bodies, small 

 spheres, usually one at each end of the bacillus. These may 

 be recognized as minute black or blue dots, which might 

 readily be mistaken for cocci. The bodies of the bacilli are 

 stained faint brown, and are often invisible. According to 

 some authorities the presence of these granules in young- cul- 

 tures of bacilli is a proof of their virulence, and the same is 

 said to be true of bacilli in films from the throat. Their pre- 

 sence, therefore,. is of some value in the recognition of the 

 true diphtheria from the "pseudo-diphtheria" bacillus, but it 

 is not absolute, as virulent bacilli occasionally exhibit no polar 

 bodies. 



INTERPRETATION OF RESULTS. 



The discovery of the diphtheria bacillus in the exudate may 

 mean 



(a) That the patient is suffering from diphtheria. 



(b) That he has suffered from diphtheria and is now con- 

 valescent, but is still infectious. The bacilli may persist for 

 weeks or months, and while they do so the patient must be 

 isolated and treated with antiseptic, g'argles. In cases where 

 the bacilli persist in spite of treatment, it is not uncommon 

 to find that the patient suffers from adenoids or enlarged 

 tonsils, and the organisms may rapidly disappear if these are 

 attended to. 



* See p. 154 for Vincent's angina. 



