1 62 CLINICAL BACTERIOLOGY AND H^EMATOLOGY 



In asthma the characteristic Curschmann's spirals may be 

 seen, and the cells will be found to consist almost entirely of 

 eosinophile leucocytes. 



THE GASTRIC CONTENTS AND VOMIT 



The bacteriological examination of the stomach contents is 

 not -of much importance except in one case i.e., in the differ- 

 ential diagnosis of carcinoma ventriculi and simple dilatation 

 of the stomach. For this purpose it is usually sufficient to 

 examine the vomit, or, if vomiting does not occur, the gastric 

 contents removed by a stomach-tube. It is quite unnecessary 

 to give a test meal, though this is advisable if a chemical 

 examination is to be made; this should be done in all doubtful 

 cases, but since the methods requisite are outside the scope of 

 this work, only a couple of simple tests will be given. 



The examination is carried out quite simply by the wet 

 method. Two or three drops of the vomit (avoiding un- 

 digested food or mucus, since the latter is likely to be derived 

 from the mouth or pharynx) are placed on a slide, and either 

 examined just as they are, or a drop of watery methylene blue, 

 gentian violet, or other stain, is added and stirred well in, and 

 the mixture covered with a cover-glass. If there is an excess 

 of fluid (so that the cover-glass is floated up), it may be sucked 

 up by means of a piece of blotting-paper; and if an oil-immer- 

 sion lens is to be used, it will be advantageous to seal the cover- 

 glass down by means of melted paraffin applied by a hot iron, 

 so as to prevent it from being lifted up by the suction of the 

 oil between the lens and cover-glass. If no positive results 

 are found in the first specimen examined, two or three more 

 should be made, as the characteristic organisms are often not 

 distributed uniformly throughout the vomit. Subsequently 

 it may be necessary to prepare dried films to determine 

 whether the organisms stain by Gram. 



In carcinoma of the stomach the characteristic features 

 are (i) the presence of the Boas-Oppler bacillus, (2) the usual 

 absence of sarcinae, and (3) the absence of hydrochloric and 

 presence of lactic acid. In addition there may be blood, pus, 

 and fragments of tumour; the latter are very rare and difficult 

 to diagnose with certainty. 



