158 CLINICAL BACTERIOLOGY AND H.EMATOLOGY 



cured, and the other apphcations of the process are too numerous 

 to mention here. In general we may say that it should be tried 

 in all chronic infective diseases that do not yield readily to easier 

 methods. 



In tuberculosis the results have been on the whole disappointing, 

 and the method should be reserved as an adjuvant to other 

 treatment, or for lesions (tuberculous iritis, ulceration of the 

 bladder, etc.) in which direct surgical treatment is unavailable. 

 Tuberculous sinuses often heal well after a few injections, and 

 tuberculous ulceration of the skin does better than ordinary lupus. 



COLLECTION OF MATERIAL AT POST-MORTEM 

 EXAMINATIONS 



The saprophytic bacteria which occur in such vast numbers in 

 the skin and alimentary canal during life undergo very rapid 

 multiplication after death ; hence, in cases where bacteriological 

 examinations have to be made, the seciio should be performed as 

 soon as possible after death. 



The materials which should be examined in all cases are the 

 heart-blood, the spleen, and the liver, and the following methods 

 are to be employed : 



The heart-blood should be collected in the method which has 

 been described previously (see p. 33), and cultures may be made 

 upon the spot, or the pipettes sealed at both ends and taken to the 

 laboratory. 



The spleen may usually be examined in the same way. If it is 

 so firm and hard that no fluid rises into the pipette, it should be 

 treated in the same way as the liver. 



Cultivations should be made from the liver at the time when the 

 autopsy is performed. The organ should be cut in half, and a 

 small portion of the cut surface deeply seared with a hot iron. 

 This area is then to be perforated with a stout platinum needle, 

 and the culture media inoculated at once. 



If the material has to be taken to a distance, and no culture- 

 tubes are at hand, a different course must be adopted. The simplest 

 way is to cut out a cube of liver substance from the centre of the ■ 

 organ, and to sear every part of its surface with the flat of a red- 

 hot knife. The block (which may be about as large as a lump of 

 sugar) must be dropped at once into a sterilized bottle. Another 



