TETANUS. 59 
(if present) will now be inoculated deep down in the 
medium, far away from the air. To reduce the supply 
of oxygen still further it is a good plan to melt some 
paraffin (a hard candle answers perfectly) and pour a 
layer an inch thick over the surface of the medium. 
The cultures thus made are to be incubated for a few 
days at the body-temperature. After about forty-eight 
hours the growth begins to appear in the deeper portions 
of the tube as a series of delicate wavy outgrowths from 
the central stab. These do not appear in the upper 
portion of the medium, where the oxygen hinders their 
growth. If the tube shows such a growth it should be 
submitted to a microscopic examination. It is a good 
plan to break the tube and to split up the cylinder of 
medium with a knife; films are made from the growth 
and stained as above. Spores are formed after about 
thirty-six hours. 
The other methods of cultural examination are far 
more difficult. 
INTERPRETATION OF RESULTS. 
If bacilli having the above characters are found in 
films, the diagnosis of tetanus must not be considered 
as being absolutely proven, for there are other bacilli 
which might be mistaken for those under discussion ; 
but the probability that the patient will develop the 
disease is so strong that steps should be taken acccord- 
ingly. The wound should be scraped and thoroughly 
treated with antiseptics, and antitoxin should be given. 
If the deeper portion of the glucose agar stab shows 
the tree-like growth which has been described and con- 
tains slender drum-stick bacilli, the case is strength- 
