64 CLINICAL BACTERIOLOGY AND H^MATOLOGY 



5. Balsam. 



6. Tubes of gelatin if cultivations have to be taken. 

 Method. Break off the extreme tip of one of the glass 



pipettes and insert into one of the vesicles around the dark 

 papule in the centre of the lesion; it may be necessary to make 

 a puncture with a sterilized needle before this can be done. 

 Aspirate the fluid gently into the pipette by means of an india- 

 rubber teat, suck it an inch or so from the tip, and seal the 

 latter in the flame. This pipette can be carried to the labora- 

 tory for further investigation. Prepare films, dry, and fix, and 

 stain one with Loffler's blue and some by Gram's method. 



Examine with the oil-immersion lens. Make a careful 

 search over the films, looking for large ^cigarette-shaped 

 bacilli, noting whether they are or are not arranged in chains. 

 Examine the Gram specimens, and see whether the bacilli are 

 to be seen in them also. 



INTERPRETATION OF RESULTS. 



If the case is really one of malignant pustule, the chances 

 are very greatly in favour of your finding the bacilli in large 

 numbers, and the failure to do so tells strongly against a posi- 

 tive diagnosis. 



Cultural Methods. The fluid for examination is taken in 

 exactly the same way as that described above, but the isolation 

 of the organisms will be greatly facilitated if antiseptic 

 methods are employed to prevent contamination with skin 

 bacteria. To this end the surface of the lesion should be 

 painted with tincture of iodine and then with alcohol or 

 methylated spirit to remove the antiseptic. The surface is 

 then allowed to dry.* 



If the material is to be transmitted to a pathologist for 

 examination (and this is the wisest course to adopt, as animal 

 inoculations are almost necessary for the absolute identifica- 

 tion of the bacillus), the fluid must be carefully sucked up into 

 the bulb, and the end of the pipette carefully sealed. 



If the examination is to be made at home, the best way is 

 to make two inoculations in gelatin. The first should be a 

 stab culture, and may be made with the pipette direct; or the 

 fluid may be blown out into a watch-glass or on to the sur- 

 face of a slide (in either case sterilized by being heated in the 

 flame and then allowed to cool), and the stab made by dipping 



