140 CLINICAL BACTERIOLOGY AND HEMATOLOGY 



endocarditis when due to this organism. When found in the blood 

 by ordinary methods it always indicates a bad prognosis, and sug- 

 gests the use of antipneumococcic serum. The identification of 

 the organism is easy and certain if present in quantities sufficient 

 for it to be found in films. 



6. Typhoid bacilli. (See p. 69.) 



7. The bacillus of glanders may be found in acute cases of that 

 disease, but its isolation and identification are matters for an 

 expert. 



8. The infliienza bacillus is present in some or, according to some 

 authorities, all cases of influenza. It may be searched for in films, 

 but no importance should be attached to a negative result. 



9. The bacillus of plague. — This organism is often present in the 

 blood in relatively large numbers, and the disease can usually 

 be diagnosed after a careful search through a number of suitably 

 stained films. But the investigation of a drop of fluid drawn 

 from the bubo (if one is present) permits of an easier and earlier 

 diagnosis. The blood examination is of most value in the pul- 

 monary and septicaemic forms of plague. 



10. The spirillum of relapsing fever is easily found, for it possesses 

 well-marked characters and is present in great numbers. The 

 diagnosis of relapsing fever cannot be made until it has been 

 demonstrated (see Fig. 32). It is best seen by mounting a small 

 drop of blood between slide and cover-glass, and examining it in a 

 perfectly fresh state, when the spirilla are easily found from the 

 commotion they cause by pushing aside the red corpuscles. 



11. The gonococcus has been found in the blood in a few cases 

 of ulcerative endocarditis. Its detection by cultural methods is 

 very difficult, and the services of a bacteriological expert should 

 be called in if the characteristic cocci are not found in blood-films 

 in a case in which the diagnosis of gonorrhoeal ulcerative endo- 

 carditis is probable, as further information upon this point is 

 greatly needed. We may point out that ulcerative endocarditis, 

 eepticsemia, etc., supervening in the course of an attack of gonor- 

 rhoea, are not necessarily due to the gonococcus. Any pathogenic 

 bacteria may enter through the lesion of the mucous membrane 

 which the gonococcus has caused. 



12. The B. coli is present in some cases of septicaemia. 



