BACTERIOLOGICAL EXAMINATION OF MOUTH AND FAUCES lOQ 



tion of the stained films by mounting a fresh wet specimen 

 between slide and cover-glass, and examining it under the oil- 

 immersion lens. 



The B. fusiformis plays a very important part in many in- 

 flammatory and ulcerative conditions in and about the mouth 

 and adjacent cavities, the teeth, etc. For instance, in association 

 with the same spirillum it is present in the pus of pyorrhoea 

 alveolaris. The lesions it causes are all associated with a foetid 

 odour, and the cultures (which are very difficult to obtain) have a 

 similar smell. 



The spirillum occurs only in the ulcero-membranous form, 

 and is present in vast numbers, usually even more plentifully 

 than the bacillus ; a well-prepared specimen is one of the most 

 striking and characteristic objects to be seen in the whole range 

 of bacteriology. It is much longer than the bacillus, very thin, 

 and either wavy and irregular in outline or thrown into definite 

 corkscrew curves. These are better seen in a wet specimen, 

 though here the active motility of the organism often makes it 

 impossible to make out its exact shape. It usually stains badly, 

 and I have missed it in specimens rapidly stained with weak 

 stains : dilute carbol fuchsin stains it very well in a quarter of a 

 minute. In one or two specimens I found the spirilla broken up 

 into chains of very minute granules, so that they resembled long 

 chains of very minute streptococci. In each case it was late in 

 the disease, so that they may have been degeneration forms. 



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

 larger and is 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 recognisable, 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 Saccharomyces 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 



