BACTERIOLOGICAL EXAMINATION OF THE NOSE, ETC. Ill 



directed up the nose from a laryngoscope mirror. Insert the tip 

 of the pipette, taking great care not to touch the vibrissae or the 

 mucous membrane near the orifice, and pass it upward until it 

 comes in contact with the pus. Then squeeze the nipple and 

 allow it to expand again, slightly moving the tip of the pipette 

 about in the pus, and taking care not to bring it in contact with the 

 mucous membrane. In most cases you will be able to suck up 

 a few drops of pus ; sometimes it is very thick and turbid, and will 

 not enter the pipette, and in this case you must use a platinum 

 loop, which is not nearly so efficacious or so easy to use. But in 



Fig. 29. — ^Angled Pipette for Collecting Pus from the Nose. 



most cases the angled pipette will be found available after a very 

 little practice. 



The organisms most frequently found in inflammation of the 

 general surface of the mucous membrane of the nose are the 

 diphtheria bacillus, the influenza bacillus, the M. catarrhalis, 

 and, less commonly, the pneumococcus. These do not call for 

 further mention. In early cases of leprosy the bacilli may be 

 found in the nose, apparently before they are present elsewhere 

 in the body, and the diagnosis may be made from their recognition. 



In suppuration of the antrum and other sinuses the bacteriology 

 is very variable. In disease of the antrum due to carious teeth 

 the B. fusifofmis, mixed with numerous other organisms, may be 

 found. In other cases the commonest bacteria are pneumococci, 

 streptococci, staphylococci, and the M. catarrhalis, usually unmixed 

 in each case ; the subject, however, has not yet been sufficiently 

 investigated. 



THE CONJUNCTIVA 



The method of examination is very simple. A little pus is taken 

 with a platinum loop and films prepared. One of these is stained 

 with carbol thionin or Loffler's blue, and the other by Gram 

 followed by dilute carbol fuchsia. 



