152 DIPHTHERIA AND PSEUDODIPHTHERIA. 



Diphtheria Diagnosis. Clinically it is not always easy to 

 differentiate diphtheria in its early stages from other affections 

 of the throat and nose which are characterized by the pres- 

 ence of exudates. In view of the recent therapeutical advances 

 in diphtheria,, it is important that a very early diagnosis be 

 made. For this purpose, accepting the almost unanimous 

 opinions of experts, that diphtheria is due to the presence of 

 diphtheria bacilli in the membranous exudate, boards of 

 health, cities, and hospitals have established a diphtheria 

 service for the purpose of facilitating the early recognition 

 of the disease. In order to carry out this method, a central 

 laboratory with all facilities is established, and in cities a 

 number of supply-depots are located within reach of the 

 practising physician, where the material in complete outfits 

 necessary to make cultures from the throats of suspected cases 

 of diphtheria may be procured. These outfits consist of a blood- 

 serum culture-tube (Fig. 59) made after the formula of Loeffler, 



FIG. 59. 



Culture-box used in municipal laboratories to prepare cultures from throats of 

 diphtheria suspects. 



and a swab or applicator kept in a well-sterilized test-tube. 

 This swab is a small iron or copper rod roughened on one of 



