i66 



CLINICAL BACTERIOLOGY AND HEMATOLOGY 



may be made tenser by gently massaging blood in it towards the 



bandage and retaining it there by a finger pressed on to the vessel. 



As soon as the requisite amount of blood has been obtained, 



remove the bandage from the upper arm, and then withdraw the 



needle ; if you withdraw the needle first there 



may be a considerable amount of haemorrhage 



into the tissues, which does no harm, but 



leaves an unsightly bruise. 



Next make the cultures as follows : Expel 

 nearly all the blood into one of the broth tubes 

 and shake gently, and then put about i c.c. 

 into the agar tube, and place the latter in an 

 inclined position, so that the blood will clot 

 in an even film over the surface. 



Seal the puncture in the skin with col- 

 lodion. If there is haemorrhage into the 

 tissues, bandage the forearm evenly from 

 below upwards. 



Undoubtedly the simplest and best of all 

 methods is that described by James and 

 Tuttle [Report of the Presbyterian Hospital, 

 New York, i8g8). " A piece of glass tubing 

 4j inches in length, and \ inch in diameter, 

 is drawn out to a tapered end, and ground 

 to fit the cap of a rather fine hypodermic 

 needle. The larger end of the tube having 

 been stopped with a cotton plug, the whole is 

 then placed in a larger tube, and both ends 

 of this are similarly plugged with cotton* 

 (Fig- 32). 



" The apparatus is then sterilized by dry 

 heat. In using it the inner tube with needle 

 attached is removed ; the skin over one of the 

 most prominent veins of the anterior surface 

 of the forearm, near the bend of the elbow, is 

 selected, a piece of rubber tubing or a few 

 turns of a bandage being passed round the arm above with 

 moderate pressure, in order to produce distension of vessels. 

 The needle is then plunged into the vessel, and generally blood 

 begins to flow by the blood-pressure itself, but any quantity 

 * These may be obtained from F. Ash, Edmund Street, Birmingham. 



Fig. 32. — Pipette 

 FOR Collection 

 OF Blood for 

 Bacteriological 

 Examination. 



