156 CLINICAL BACTERIOLOGY AND H^MATOLOGY 



and is present in vast numbers, usually even more plentifully 

 than the bacillus; a well-prepared specimen is one of the most 

 striking and characteristic objects to be seen in the whole 

 range of bacteriology. It is much longer than the bacillus, 

 very thin, and either wavy and irregular in outline or thrown 

 into definite corkscrew curves. These are better seen in a 

 wet specimen, though here the active motility of the organism 

 often makes it impossible to make out its exact shape. It 

 usually stains badly, and I have missed it in specimens rapidly 

 stained with weak stains : dilute carbol fuchsin stains it very 

 well in a quarter of a minute. In one or tw y o specimens I 

 found the spirilla broken up into chains of very minute 

 granules, so that they resembled long- chains of very minute 

 streptococci. In each case it was late in the disease, so that 

 they may have been degeneration forms. 



The spirillum differs from that of syphilis in that it is much 

 larger and more easily stained by ordinary dyes, and the two 

 could hardly be mistaken. It is to be noted, however, that 

 the B. fusiformis is not uncommon in syphilitic lesions. 



SCARLATINAL ANGINA cannot be diagnosed with certainty 

 from other forms of sore throat by bacteriological methods. 

 It is usually due to a streptococcus which occurs in very long 

 chains and is somewhat characteristic, but which cannot be 

 differentiated from other forms of streptococci by simple 

 means. 



THRUSH is usually easily recognizable, but when this is not 

 the case a Gram-stained specimen of the membrane will im- 

 mediately settle the diagnosis. The specific organism, the 

 Oldium albicans or Sac char omyces albicans, is a mould which 

 appears in the form of larg~e and thick branching mycelial 

 filaments which stain deeply by Gram's method, and which 

 are interspersed with large round or oval spores, which also 

 stain readily and deeply. The organism can be readily differ- 

 entiated from the bacterial filaments which may occur in the 

 mouth (leptothrix, etc.) by its relatively enormous size. When 

 cultivated for a day or two on ordinary media mycelium forma- 

 tion does not take place, or only to a very limited extent, and 

 the oval or spherical spores are often mistaken for yeasts. 



SYPHILITIC ANGINA may be recognized by the identification 

 of the Spirochceta pallida, but some caution is necessary, since 

 non-pathogenic spirilla are frequently present in the healthy 



