100 STUDY AND IDENTIFICATION OF BACTERIA 



aqueous acid solutions. There is a great variation in the resistance to 

 decolorization of leprosy bacilli, a preparation from one case holding its 

 color almost as well as tubercle bacilli, while material from another 

 case may decolorize very easily. 



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I am partial to Tschernogabow's technic. In this one punctures the sub- 

 epithelial granulomatous tissue with a capillary pipette, the end of which has been 

 broken off by tapping the point in order to give a cutting point, and the serum which 

 exudes is smeared out and stained. 



Some prefer emulsifying a piece of the tissue and centrifuging and staining the 

 sediment. Quite recently the antiformin method of treating leprous tissue, as for 

 tuberculous tissue, has been used. 



Many insist that the best method is to cut out small sections of the lesion, going 

 well into normal tissue, and putting through paraffin and cutting thin sections and 

 staining. Gram's method, counterstaining with Bismark brown gives beautiful 

 preparations. For acid-fast staining first stain with haematoxylin to obtain a his- 

 tological background and then steam with carbol-fuchsin, decolorize very briefly 

 with acid alcohol, then through absolute alcohol and xylol. 



Of the greatest diagnostic value is the staining of the nasal mucus 

 or scrapings from ulcerations on nasal septum for leprosy bacilli. 

 These are often found in the characteristic cigar package bundles or 

 engulfed in lepra cells. A standard procedure is to give 60 grains of 

 iodide of potash to cause a drug coryza, in the secretions of which lep- 

 rosy bacilli may be found. However, one will have better success if 

 the nasal secretion be obtained at a time when a natural coryza exists. 



Thibault examined the nasal mucus, gland juice and blood of 30 lepers. He 

 obtained leprosy bacilli in the nasal mucus of 20, in the gland puncture juice of 18, 

 and in the blood of 7. 



Hollman detected leprosy bacilli in the nasal mucus of 90% of 58 nodular 

 cases, of 67% of 6 mixed leprosy and of 45% of anaesthetic cases, after making 329 

 examinations. 



Leprosy bacilli are apt to be found in the blood of nodular cases, especially at the 

 time of the febrile accessions. The blood is best taken in 5 or 10 c.c. quantities into 

 i% sodium citrate in distilled water. After centrifuging, the sediment is treated 

 with 10% antiformin, at 37C. for one hour. Again centrifuging, and washing, the 

 sediment is smeared out on a slide and stained. The bacilli are not apt to be found 

 in the blood of cases of nerve leprosy. 



Gland puncture has recently been considered as an important diagnostic procedure 

 in leprosy. 



It must not be forgotten that while the finding of leprosy bacilli is 

 usually very easy in the nodules of nodular leprosy it is a painstaking 

 and discouraging procedure with the spots of nerve leprosy. Even the 



