158 CLINICAL BACTERIOLOGY AND H/EMATOLOGY 



To use it, seat yourself opposite to the patient, insert a nasal 

 speculum sterilized in carbolic acid or in the flame, and 

 examine the nose in the ordinary way by means of a beam of 

 light directed up the nose from a laryng-oscope mirror. Insert 

 the tip of the pipette, taking great care not to touch the 

 vibrissae or the mucous membrane near the orifice, and pass it 

 upward until it comes in contact with the pus. Then squeeze 

 the nipple and allow it to expand again, slightly moving the 

 tip of the pipette about in the pus, and taking care not to bring 

 it in contact with the mucous membrane. In most cases you 

 will be able to suck up a few drops of pus; sometimes it is very 

 thick and turbid, and will not enter the pipette, and in this case 

 you must use a platinum loop, which is not nearly so efficacious 

 or so easy to use. But in most cases the angled pipette will 

 be found available after a very little practice. 



The organisms most frequently found in inflammation of 

 the general surface of the mucous membrane of the nose are 

 the diphtheria bacillus, the influenza bacillus, the M. catar- 

 rhalis, the pneumococcus, the pneumobacillus, and B. septus. 

 These do not call for further mention. In early cases of 

 leprosy the bacilli may be found in the nose, apparently before 

 they are present elsewhere in the body, and the diagnosis may 

 be made from their recognition. 



In suppuration of the antrum and other sinuses the bac- 

 teriology is very variable. In disease of the antrum due to 

 carious teeth the B. fusifomds, mixed with numerous other 

 organisms, may be found. In other cases the commonest 

 bacteria are pneumococci, streptococci, staphylococci, and the 

 M. catarr kalis, usually unmixed in each case; the subject, how- 

 ever, has not yet been sufficiently investigated. 



THE CONJUNCTIVA 



The method of examination is very simple. A little pus is 

 taken with a platinum loop and films prepared. One of these 

 is stained with carbol thionin or LorBer's blue, and the other 

 by Gram followed by dilute carbol fuchsin. 



The most common causes of conjunctivitis are the gonococ- 

 cus, the pneumococcus, the Koch-Weeks bacillus, and the 

 bacillus of Morax and Axenfeld. In addition to these, certain 

 other bacteria must be briefly mentioned. 



