TUBERCLE Jl 



abscess is opened, but may be detected by inoculation experi- 

 ments for long periods. 



Clear exudates are more difficult to examine, and as they 

 usually contain bacilli in very small numbers only, a negative 

 result should not be given too much weight. For the best 

 method to employ, see section on Cyto-diagnosis, p. 290. The 

 examination is best made in a bacteriological laboratory, as 

 decisive results can only be obtained by animal experiments. 

 Collect the fluid in a bottle which has previously been boiled 

 in water for half an hour and allowed to cool. Cork it with a 

 cork which has also been boiled. Add no antiseptic, and 

 forward it to the laboratory as soon as possible. 



Milk may be examined in the same way as urine, films being 

 made from the cream as well as from the deposit. These 

 films are fixed, soaked in ether to remove fat, and again 

 fixed. They are then stained as before, and it is advisable to 

 pass them through alcohol. 



The results obtained by this examination are somewhat 

 uncertain, as some .of the other acid-fast bacilli found in milk 

 are almost exactly like the tubercle bacillus, and animal ex- 

 periments are necessary for definite proof. 



When faeces are to be examined, the best plan is to 

 administer opium in amount sufficient to cause constipation. 

 The surface of the scybalous motions which result are to be 

 scraped off and stained in the usual way. Or the material 

 may be examined by the antiformin method. 



INTERPRETATION OF RESULTS. 



The finding of tubercle bacilli in the sputum is conclusive 

 evidence of tuberculosis of the lungs, but no information as 

 to prognosis can be drawn from the numbers which are pre- 

 sent; they may occur in great quantities in the sputum from 

 patients who are doing well, and the author has found enor- 

 mous numbers in the sputum of a person who had presented 

 no symptoms of the disease for eight years, and was appar- 

 ently, cured. But a person in whom the bacilli are present is 

 always in danger of a recrudescence of the disease, and may 

 be a source of infection. Absence of the bacilli does not dis- 

 prove the diagnosis of tuberculosis; bacilli do not appear in 

 the sputum until the lung-tissue in which they occur breaks 



