RINGWORM 139 



arranged in chains. It is rather thick in proportion to its 

 length, its length being only about three times its breadth, 

 and it has rounded ends, which often stain more deeply than 

 the centre of the bacillus. It does not stain by Gram's 

 method; it stains, indeed, with some difficulty, and powerful 

 stains (such as dilute carbol fuchsin or Loffler's blue) should 

 be used. It is best demonstrated in films made from the 

 deeper parts of a typical soft sore, for the superficial parts 

 contain bacteria of all sorts, and the recognition of Unna's 

 bacillus is not easy unless it is obtained in large numbers. 



The bacteriological examination for this bacillus has most 

 often to be made in cases of urethral sore, or of a sore con- 

 cealed beneath a phimosis. The method of obtaining the 

 specimen is the same in both cases. A fairly stiff platinum 

 loop is inserted beneath the prepuce, or into the urethra, and 

 moved gently about until the most tender spot is found. This 

 should be scraped as forcibly as the patient will allow, and the 

 loop withdrawn, care being- taken that the mass of secretion 

 is not wiped off in so doing. Several films should then be 

 made, the secretion being rubbed up on the slide with a drop 

 of water. They should be stained with either of the stains 

 mentioned above for five minutes or more : it is an advantage 

 to warm them gently. They are then rinsed in water, dried 

 and mounted, and examined thoroughly with an oil-immer- 

 sion lens. 



When buboes occur in the course of soft sore, the pus they 

 contain should be examined for this organism as soon as 

 they are opened; the interest in this is chiefly scientific, for 

 opinions are divided as to whether they are caused by this 

 germ or by pyogenic bacteria. In three cases examined by 

 the author it was found (in very scanty numbers) on one 

 occasion, staphylococci on another, and no bacteria of any 

 sort on the third. 



RINGWORM 



An examination of the hair and scales from the skin is of 

 very great value to the dermatologist. It settles conclusively 

 the question whether a patient is or is not suffering from 

 ringworm, and often gives important information as to prog- 

 nosis, and may enable us to say whether the disease has 

 probably been derived from a human source, or has been 

 contracted from one of the lower animals. 



