390 



ANTIFORMIN 



merit 



A mark with a grease pencil, about ^ inch from the end, gives a convenient 

 surface to hold with the forceps and also prevents the stain subsequently used from 

 running over the entire surface. A piece of glass tubing about 1 2 inches long bent 

 into a narrow V shape makes a very satisfactory rest for the slide in staining and is 

 convenient for the steaming of staining solution over the flame. 



Sputum should as a routine measure be stained by the Ziehl-Neelson method and 

 by Gram's method. 



In examining for tubercle bacilli it may be necessary to employ some method for 

 concentrating the bacterial content of the sputum prior to making the smear. A 

 very satisfactory method is that of Miihlhauser-Czaplewski. Shake up the sputum 

 with four to eight times its volume of %% solution of sodium hydrate in a stoppered 

 bottle. When the mixture has become a smooth, mucilaginous-looking fluid, add a 

 few drops of phenolphthalein solution and bring the pink mixture to a boil. 



Then add drop by drop a 2% solution of acetic acid, stirring constantly, until 

 the pink color is just discharged. If the least excess of acid is added over that just 

 sufficient to cause the pink color to disappear, mucin will be precipitated. Now pour 

 this mixture into a centrifuge tube and smear the sediment on a slide and stain for 

 tubercle bacilli. 



Antifonnin. Tubercle bacilli usually occur nested in clumps of 

 sputum. Therefore, when few in number it is only by chance that they 

 may be found. Concentration methods aim to dissolve these clumps 

 of sputum and collect, free from mucus, whatever bacilli may be 

 present. There are many concentration methods for sputum. One 

 of these has been given above. Uhlenhuth's method has some 

 advantages over others in the solvent used: i. It breaks up the 

 sputum very rapidly; 2. it immediately dissolves all organisms except 

 acid-fast ones; 3. applied in not too concentrated form and for not 

 too long a time, tubercle bacilli are not killed, so that by washing 

 the sediment carefully by several dilutions and centrifugings we have 

 in the sediment viable tubercle bacilli which we may attempt to 

 cultivate upon Dorsett's or other suitable media with the reasonable 

 hope that contaminations will not choke them out or prematurely 

 kill the inoculated guinea-pig; 4. it has less effect upon the staining 

 properties of tubercle bacilli than any other material used in 

 concentration methods. PetrofTs method is probably better. 



To make this solvent (antiformin) take double the quantity of chlorinated lime 

 and sodium carbonate required by the U. S. Pharmacopoeia and prepare according 

 to U. S. P. directions. To the finished liquor sodae chlorinatae (Labarraque's solu- 

 tion) add 7^% of sodium hydrate. 



The Liquor sodae chlorinatae 'of the Br. P. is slightly stronger and some English 

 authorities recommend a mixture of equal parts of this Labarraque's solution and 

 15% sodium hydrate solution. As a rule i part of antiformin to 5 parts of sputum 

 is sufficient. Very tenacious sputum may require i part to 4 parts of sputum. 



