EXAMINATION FOR BACTERIA. I71I 
the investigation of a drop of fluid drawn from the bubo 
(if one is present) permits of an easier and earlier diag- 
nosis. The blood examination is of most value in the 
pulmonary and septicemic forms of plague. 
10. The spivillum of relapsing fever is easily found, for 
it possesses well marked characters and is present in 
great numbers. The diagnosis of relapsing fever can- 
not be made until it has been demonstrated. 
11. The gonococcus has been found in the blood ina 
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 gonorrhceal ulcerative 
endocarditis is probable, as further information upon 
this point is greatly needed. We may point out that 
ulcerative endocarditis, septicemia, &c., supervening in 
the course of an attack of gonorrhcea 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 bacillus coli is present in some cases of septi- 
cemia. 
EXAMINATION FOR BACTERIA IN FILMS. 
This is the easiest method in which bacteria may be 
found in the blood, and it does not require such a rigid 
antiseptic technique as is necessary if cultures are to be 
taken. The films are prepared and fixed in one or 
other of the methods which we have described, the only 
point worthy of notice being that the skin must be very 
