nS 



MEDICAL BACTERIOLOGY 



EXAMINATION OF PUS, SPUTUM AND SEROUS EFFUSIONS 



When abscess formation, peritonitis, pleurisy, meningitis or pneumonia 

 occurs during the course of typhoid fever or under circumstances which suggest 

 the typhoid bacillus as a probable cause, some of the pus or fluid exudate should 

 be planted on the surface of Endo's agar plates with a platinum loop, incu- 

 bated, and if typhoid-like colonies appear they are subcultured and examined 

 microscopically. 



EXAMINATION OF BILE 



A. L. Garbat states that the urine may contain bacilli when the feces and 

 bile do not; that the feces may contain them when the urine and bile do not; 

 that the bile alone may reveal bacteria; that all three urine, feces and bile 

 should be examined, before typhoid patients are discharged and when an 

 individual is suspected of being a carrier. 



He states that the examination of bile for typhoid bacilli is easier than the 

 examination of feces and frequently yields pure cultures of them when examina- 

 tion of feces discloses none. He recommends the following technique: 



Have patient swallow an Einhorn duodenal tube when retiring at night; give 

 a liquid breakfast the following morning; i% hours after breakfast pour 10 ounces 

 of sterile normal salt solution through tube; ^ hour later withdraw bile from 

 tube with a sterile syringe and plant the contents of syringe in plain broth and 

 on agar; if growth occurs, make subcultures to determine whether typhoid or 

 other bacilli have been obtained. 



