TUBERCLE 69 



to mistakes unless the sample examined was drawn off per 

 catheter. It is distinguished by the fact that it is readily 

 decolorized by alcohol (absolute alcohol or methylated spirit), 

 while the tubercle bacillus is not. In staining a film from 

 the urine, we decolorize in spirit for a quarter of an hour after 

 the acid, and before the methylene blue i.e., between stages 

 3 and 4 in the above description. 



In searching for the tubercle bacillus, the J-inch lens will 

 serve, though an oil-immersion lens is an advantage. 



METHOD OF COLLECTING THE SPUTUM. 



This is of some importance, and the method recommended 

 should be carried out in all cases. 



Get the patient to wash out his mouth thoroughly with 

 warm water before going to bed. Let him spit into a clean 

 bottle, jar, or tin, and employ only the sputum coughed up 

 before food is taken in the morning. 



It is often impossible to get sputum from children, but in 

 them it is often possible to pick masses of sputum out of the 

 vomit and to demonstrate tubercle bacilli therein; and when 

 no such masses are seen, bacilli may occasionally be found 

 if the whole vomit be carbolized or treated with antiformin 

 in the manner described subsequently and the sediment 

 examined. In some cases in which there is no vomit it is 

 occasionally justifiable to give an emetic for the purpose of 

 securing sputum and establishing the diagnosis. 



METHOD OF PREPARATION OF THE FILM. 



Sputum. Pour the sputum into a Petri dish or watch-glass, 

 and place the vessel upon a dark surface. Examine it closely, 

 looking out for small yellow particles; these consist of 

 caseous material, and will probably contain tubercle bacilli in 

 large numbers. The advantage of getting the patient to 

 wash out his mouth and using only fasting sputum is 

 obvious, for particles of food may present exactly the same 

 appearance. 



Having found such a mass, pick it out by means of a 

 platinum loop or pair of forceps, and transfer it to the middle 

 of a clean slide. Now place another slide on the top of the 



