EXAMINATION OF THE NOSE AND ACCESSORY CAVITIES 157 



mouth. The films stained by appropriate stain must be very 

 carefully compared with others stained by simple dyes (thionin 

 or methylene blue), to make sure that the organism found is 

 not coloured by ordinary means. 



THE BACTERIOLOGICAL EXAMINATION OF THE 

 NOSE AND ACCESSORY CAVITIES 



In health the nasal mucous membrane is sterile except for 

 that portion in close proximity to the orifices; the vibrissse are 

 especially contaminated with air-borne organisms, and contact 

 with them must be avoided if cultures are being taken. 



Methods. In most cases a simple microscopical examina- 

 tion of the mucus, muco-pus, or pus from the nose is sufficient, 

 and the material may be taken from the patient's pocket-hand- 

 kerchief immediately after he has blown his nose. Where 



FIG. 27. ANGLED PIPETTE FOR COLLECTING Pus FROM THE NOSE. 



cultures are required the methods are more difficult, and the 

 material must be collected as near as possible to the region 

 where it is secreted ; this is especially the case in the examina- 

 tion of the pus from cases of empyema of the antrum, frontal 

 sinus, etc. I have found the most convenient instrument is a 

 long capillary pipette of rather wide calibre, and bent to an 

 angle of about 135 degrees, at a point some 4 inches from its 

 tip, which must be carefully rounded in the flame, so as not to 

 injure the mucous membrane. It is provided with an india- 

 rubber nipple, and is readily prepared from one of the straight 

 pipettes described on p. 34, by heating it gently in a spirit- 

 lamp, at a point about 4 inches from the tip, until the glass is 

 just softened, and then allowing the distal end to fall until the 

 proper angle is reached. The pipette may be sterilized by 

 passing it rapidly through the flame, taking* care not to melt it. 



