128 CLINICAL BACTERIOLOGY AND HiEMATOLOGY 



The spirillum differs from that of syphilis in that it is much 

 larger and more easily stained by ordinary dyes, and the two could 

 hardly be mistaken. It is to be noted, however, that the 

 B. fusiformis is not uncommon in syphilitic lesions. 



Scarlatinal Angina cannot be diagnosed with certainty from 

 other forms of sore throat by bacteriological methods. It is usually 

 due to a streptococcus which occurs in very long chains and is 

 somewhat characteristic, but which cannot be differentiated from 

 other forms of streptococci by simple means. 



Thrush is usually easily recognizable, but when this is not the- 

 case a Gram-stained specimen of the membrane will immediately 

 settle the diagnosis. The specific organism, the O'idium albicans 

 or Sacchayomyces albicans, is a mould which appears in the form 

 of large and thick branching mycelial filaments which stain deeply 

 by Gram's method, and which are interspersed with large round 

 or oval spores, which also stain readily and deeply. The organism 

 can be readily differentiated from the bacterial filaments which 

 may occur in the mouth (leptothrix, etc.) by its relatively enormous 

 size. When cultivated for a day or two on ordinary media 

 mycelium formation does not take place, or only to a very limited 

 extent, and the oval or spherical spores are often mistaken for 

 yeasts. 



Syphilitic Angina may be recognized by the identification of 

 the Spirillum pallida, but some caution is necessary, since non- 

 pathogenic spirilla are frequently present in the healthy mouth. 

 The films stained by Giemsa's stain must be very carefully 

 compared with others stained by simple dyes (thionin or methylene 

 blue), to make sure that the organism found is not coloured by 

 ordinary means. 



THE BACTERIOLOGICAL EXAMINATION OF THE 

 NOSE AND ACCESSORY CAVITIES 



In health the nasal mucous membrane is sterile except for that 

 portion in close proximity to the orifices ; the vibrissse are espe- 

 cially contaminated with air-borne organisms, and contact with 

 them must be avoided if cultures are being taken. 



Methods.- — In most cases a simple microscopical exarriination of 

 the mucus, muco-pus, or pus from the nose is sufficient, and the 

 material may .be taken from the patient's pocket-handkerchief 



