88 CLINICAL BACTERIOLOGY AND HEMATOLOGY 



process being adopted as in the preparation of blood-films (see 

 p. 218), except that it will be necessary to squeeze the two lightly 

 together. The fixation is accompHshed by passing the cover- 

 glasses vapidly through the flame. 



These are the methods by which films are spread in all cases ; 

 the way in which the pus should be obtained varies somewhat 

 with the nature of the case. 



In the male it is advisable to cleanse the meatus and to reject 

 the first drop of pus, taking the second with a platinum loop and 

 proceeding as before. Antiseptic precautions are entirely un- 

 necessary, unless an attempt is to be made to get cultures. If 

 the patient is suffering from phimosis, and there is a purulent 

 discharge, which may be due to gonorrhoea, chancre, soft sore, or 

 to a non-specific balanitis, a similar method is adopted ; but here 

 many films should be taken, as a prolonged search may be 

 required. If the patient suffers from a slight discharge in the 

 early morning, the best plan is to give him two clean slides. 

 These are to be smeared across the meatus whilst wet with the 

 discharge, and allowed to dry. 



In the female it is necessary to obtain the pus directly from the 

 urethra ; it may be expressed by the finger in the vagina. The 

 first drop should be rejected. 



If the patient is suffering from cervicitis or endometritis, the 

 pus should be taken direct from the cervix, a speculum being 

 used, and the pus being removed by a platinum loap or probe. It 

 is necessary to emphasize the fact that the material must be from 

 these regions if a negative result is to be of any value. The flora 

 of the vagina in all cases of discharge is so extraordinarily 

 abundant that it is almost impossible to recognize the gonococcus 

 with certainty in such material. 



It is absolutely necessary that you should spread the films 

 at once, even if you are having the examination made at a distance. 

 It is next to useless to send pus dried on linen, cotton-wool, a 

 Volkmann's spoon, or even in a thick layer on a slide. The 

 diagnosis may be made from material sent in this way, but the 

 difficulties are much greater, and in some cases the results are 

 less certain. 



Preparation of films from conjunctival pus presents no diffi- 

 culties. The same is true of pus from the tubes or other internal 

 regions, whether it is exposed by operative interference or at a 

 post-mortem examination. 



