INFLUENZA 53 



certain of finding PfeifFer's bacillus if they occurred a few years 

 back, we now find other organisms, especially the Micrococcus 

 catarrhalis. In this uncertain state of bacteriology the results of 

 an examination of the sputum are deprived of much of their value 

 as a means of diagnosis, but the methods will be described, since 

 more information is required, and this information the general 

 practitioner is usually in the best situation to obtain. 



Methods. — If possible, the sputum should be obtained in a method 

 similar to that recommended in pneumonia, as it greatly facilitates 

 the process and renders the results more trustworthy if the sputum 

 comes directly from the lungs, and is not contaminated with bacteria 

 from the mouth. The nasal secretion may also be examined, and 

 frequently contains the organisms in pure culture and vast numbers ; 

 where the nose is affected, better results will be obtained in this 

 way than from the sputum. The mucus may be collected on a 

 diphtheria swab or on a platinum loop, or by means of one of the 

 angled pipettes described on p. no, though it is often too thick to 

 be sucked up into such a narrow tube. 



Films are prepared from the sputum by squeezing a small mass 

 between two slides and sliding them apart. Dry and fix by heat. 

 Two should be prepared. The first should be stained by Gram's 

 method, and counterstained by dilute carbol fuchsin for a quarter 

 of a minute, then washed, dried, and mounted. The other is to be 

 stained more deeply with carbol fuchsin or Loffler's blue — about 

 five minutes with gentle heat in either case. The influenza bacillus 

 stains with difficulty, and may not be seen in the Gram's specimen 

 which is lightly stained with fuchsin. And there is a good reason 

 for not carrying the counterstaining too far in the former case, 

 since if the carbol fuchsin is used for too long a time it may dis- 

 place the violet stain of an organism which retains Gram. 



The influenza bacillus is an extremely minute organism, and one 

 which requires the highest powers of the microscope for its study. 

 It is an extremely minute rod, and it would take from eight to 

 sixteen of these rods to make up the diameter of a red blood- 

 corpuscle. They occur in vast numbers in the sputum or nasal 

 mucus, and are frequently found within the leucocytes, and when 

 in this situation may appear to have a capsule, being contained in 

 vacuoles in the protoplasm (Plate II., Fig. 3). They are often 

 arranged in pairs, in which case they might be mistaken for small 

 but unusually elongated pneumococci, but for the fact that they do 

 not stain by Gram's method. 



