68 CLINICAL BACTERIOLOGY AND HiEMATOLOGY 



was not suspected ; once in an enlarged tonsil ; once in an appar- 

 ently typical case of cancer of the breast, etc. 



The films should be carefully examined for the presence of 

 these structures. Clubs are not likely to be found in the pus, 

 and their absence does not tell against the diagnosis ; the dense 

 felted network of filaments retaining Gram's stain is what is to be 

 looked for, and its presence is quite sufficient for a diagnosis. 

 Fortunate specimens may show a complete colony, with its 

 irregular network in the centre and the radial arrangement of the 

 fibres on the periphery, or there may be mere fragments of 

 mycelium. 



GLANDERS 



Glanders is one of the infective granulomata, and is closely 

 allied to tuberculosis ; it differs, however, in running a more rapid 

 course and in the greater tendency which the specific lesions 

 exhibit to undergo suppuration. It is caused by the B. mallei, 

 an organism which is nearly as long as the tubercle bacillus, 

 and decidedly thicker. It stains readily with all stains, and is 

 easily decolorized ; it loses its stain when treated by Gram's 

 method, and does not form spores. 



The bacteriological diagnosis of the disease is not easy, and 

 should be referred to a bacteriologist. A quantity of the discharge 

 from a suspected case should be taken with aseptic precautions, 

 and transmitted as soon as possible in a test-tube or bottle which 

 has been sterilized by dry heat or by boiling. Pus had better be 

 sent in a pipette. 



Where abscesses are opened, cultures taken direct from the pus 

 may possibly contain the bacillus in pure culture. In this case it 

 may be identified by the characters of its growth upon potato. 

 The colonies have the colour and appearance of honey at first ; 

 they grow very rapidly, coalesce, and the potato is soon covered 

 with a moist-looking film, which afterwards becomes brown, the 

 surface of the medium in the neighbourhood becoming greenish- 

 brown. If cultures from pus grown on potato exhibit these 

 appearances, and contain a short and thick bacillus which does 

 not stain by Gram's method, the case may be diagnosed as being 

 probably one of glanders, even although the culture be not a 

 pure one. 



