EXAMINATION IN SEPSIS 287 



gunshot wounds and gangrenous conditions, with development of 

 gas (see Chapter XIII). 



y. The tetanus bacillus is found in the wound in cases of trau- 

 matic tetanus (see Chapter XIII). 



5. The typhoid bacillus is rare ; it may occur in suppurative 

 conditions complicating or following typhoid fever. Proceed as 

 in 3 and 4 (see also p. 430). 



. When the Bacillus pyocyaneus is present the pus or discharge 

 may be blue. Proceed as in 3 and 4. 



(g) If yellow granules, having a rosette-like structure micro- 

 scopically, are present, actinomycosis may be suspected and 

 examined for by the methods given in Chapter XV. 



(h) If thread forms be present, streptothrix or aspergillar infec- 

 tion may be suspected (see Chapters XV and XVII) : if large 

 round or ovoid cells or yeast-like forms, Blastomycetes or Sporo- 

 trichon (Chapter XVI). 



(i) If a mixture of organisms be present, agar, gelatin and other 

 plate cultivations should be prepared and further examined by 

 subcultures from the colonies. 



(j) If no organisms can be detected microscopically, proceed as 

 in 3 and 5. In the pus of ordinary abscesses micro-organisms 

 can generally be detected, unless caused by the tubercle or 

 glanders bacillus, the pneumococcus, or the Entamceba. In 

 broken-down granulomata, e.g. gummata, if unopened, no 

 organisms may be present. 



(3) Make several cultivations on agar, gelatin, or other suitable 

 media (anaerobic if required), and examine microscopically and 

 by subcultures when the growths have developed. 



(4) Make plate cultivations on agar, blood agar, serum, gelatin, 

 or other media. Examine the colonies microscopically and by 

 subcultures. 



(5) Inoculate guinea-pigs or mice subcutaneously and intra- 

 peritoneally with the material. 



(6) Organisms can rarely be detected in the blood by a micro- 

 scopical examination of stained films. Therefore 2-5 c.c. of 

 blood should be withdrawn and cultivated (p. 142). 



(7) If the abscess be probably a tropical abscess of the liver, the 

 pus or scrapings from the wall of the abscess should be examined 

 for the presence of the Entamceba (Chapter XVIII). 



Diphtheroid bacilli are frequent in wounds. 



