TETANUS 51 



made from the growth and stained as above. Spores are formed 

 after about thirty-six hours. 



The other methods of cultural examination are far more 

 difficult. 



Interpretation of Results. 



If bacilli having the above characters are found in films, the 

 diagnosis of tetanus must not be considered as being absolutely 

 proven, for there are other bacilli which might be mistaken for 

 those under discussion ; but the probability that the patient will 

 develop the disease is so strong that steps should be taken 

 accordingly. The wound should be scraped and thoroughly 

 treated with antiseptics, and antitoxin should be given. If the 

 deeper portion of the glucose-agar stab shows the tree-like 

 growth which has been described and contains slender drum- 

 stick bacilli, the case is strengthened, even although the upper 

 part of the medium is contaminated with other organisms. 



The only way in which the bacilli can be recognized with 

 absolute certainty is by means of animal experiments ; this is a 

 very certain method, and one that can be carried out in the 

 absence of pure cultures. The material is diluted with some 

 broth and divided into two parts, of which one is injected into an 

 animal just as it is, whilst the other is mixed with antitetanic 

 serum and then injected. In a case of tetanus, the first animal 

 will die with tetanic symptoms, whilst the latter will survive or 

 die of sepsis without tetanus. 



THE PNEUMOCOCCUS, PNEUMONIA, ETC. 



The pneumococcus is a very important organism, and one 

 which plays a prominent part in the production of disease. It 

 may occur in the mouth in a healthy person ; hence its recogni- 

 tion in small quantities in the sputum is not of diagnostic value. 



The pneumococcus is a very common cause of disease of the 

 respiratory system. It causes : 



1. AnUe lobar pneumonia, of which it is the only common cause. 



2. Lobular (broncho-) pneumonia. This disease may also be caused 

 by streptococci, staphylococci, diphtheria bacilli, influenza bacilli, 

 plague bacilli, tubercle bacilli, and others. The pneumococcus 

 may also occur as a secondary infection in lobular pneumonia due 

 to any of these. 



