124 CLINICAL BACTERIOLOGY AND HEMATOLOGY 



THE BACTERIOLOGICAL EXAMINATION OF THE 

 MOUTH AND FAUCES 



The method of examination of the morbid products of the mouth 

 and fauces in diphtheria has been explained in full, and the 

 methods which are used in other conditions are similar in nature. 



The more important of these allied conditions are : 



Simple angina and follicular tonsillitis. 

 Vincent's angina. 

 Scarlatinal angina. 

 ' Thrush. 



Syphilitic angina. 



Methods. — An examination of a film stained by a simple stain, 

 and of a second prepared by Gram's method, is usually all that 

 is necessary, but it is advisable to be prepared to make cultures 

 subsequently if thought requisite. If the patient is seen at some 

 distance from the laboratory, the material is best collected on a 

 sterilized swab such as is used for diphtheria in the method de- 

 scribed on p. 41, taking great care to rub it on the affected area. 

 When this is brought to the laboratory, two smears are to be 

 made on slides which have just been sterilized by being heated in 

 the flame, and which have been allowed to cool. As soon as the 

 films have been prepared the swab is to be returned to its sterile 

 tube and kept in readiness for the preparation of cultures, should 

 they be required. It is better to take a second swab, and to keep 

 it until the films have been examined. 



When the patient can be brought to the laboratory it is more 

 convenient to collect the material with a platinum loop. A good 

 loopful of the material is removed, laid on a clean shde, and two 

 films prepared by pressing a second slide firmly on the first and 

 sliding them apart. If there is any difference between the two, 

 the thicker is used for staining by Gram's method. This is fixed 

 in the flame in the usual way, stained by aniline gentian violet 

 (3 minutes), rinsed, fixed in Gram's iodine solution, decolorized in 

 methylated spirit or absolute alcohol until no more colour comes 

 out, stained in dilute (i in 5 or i in 10) carbol fuchsin for a quarter 

 of a minute, washed, and dried. The other film is best stained by 

 carbol thionin, but Loffler's blue answers very well. 



The examination of the films is made at once, and will show 



