tests, the one-fifth volume Kolmer with 
Reiter protein antigen (KRP) and Fluores- 
cent Treponemal Antibody (FT A) tests. 
(1) Collection tubes should be clean, dry, 
and sterile to prevent contamination 
and hemolysis of the specimen. Vacu- 
um tubes or tubes with paraffin-coated 
corks may be used. 
(2) At least 5 to 8 ml. of blood should be 
drawn, placed in the tube aseptically, 
and allowed to clot at room tempera- 
ture. Store the specimen in the refrig- 
erator until the specimen is sent to the 
laboratory. Specimens should not be 
placed in the mail over long weekends 
or holidays when delivery may be de- 
layed. 
NOTE: Hemolysis may be caused by wet 
or dirty syringes, needles, or tubes; 
chemicals; freezing; or extreme 
heat. 
( 3 ) If serum is submitted to the laboratory, 
submit information as to whether or 
not it has been heated (giving time and 
temperature) and if preservatives have 
been added. 
e. Spinal fluid specimens for nontreponemal 
tests and total protein determinations 
(1) Collection tubes should be clean and 
sterile. (Merthiolated tubes may be 
prepared for the collection of the spec- 
imens: prepare a 1% aqueous solution 
of Merthiolate; place 0.1 ml. in a clean, 
sterile tube; and dry in a desiccator 
over CaCl 2 . This compound curtails 
bacterial growth without interfering 
with the nontreponemal tests for syphi- 
lis and does not affect the results ob- 
tained with the turbidimetric methods 
for determining total proteins in spinal 
fluids.) Stopper with paraffin-coated 
corks. 
(2) Collect 2 to 8 ml. of spinal fluid asepti- 
cally. 
(3) If the specimen is centrifuged before 
sending it to the laboratory, note the 
original condition or appearance of the 
specimen on the request slip. 
NOTE: Specimens grossly contaminated 
with blood or bacteria are unsatis- 
factory for testing. 
13. Tuberculosis. Since Mycobacterium tuberculosis 
may invade any organ of the body, such varied 
specimens as sputum, gastric washings, pus, 
urine, or spinal fluid may be sent to the labora- 
tory for examination. Sputum is the specimen 
most frequently submitted. Patients must be 
taught the difference between saliva and sputum 
and told that an early morning specimen is 
generally most productive. They should also be 
cautioned against contaminating the exterior of 
the container, as such contamination creates a 
hazard for all who handle the specimen. 
Pooling of sputum for several days is not desir- 
able because it may be toxic to tubercle bacilli 
present and the degree of contamination may 
be increased. Specimens must be sent through 
the mails in sterile screw-capped containers 
having resilient rubber liners in the caps. Pack- 
aging must be in double mailing containers. The 
need for examination of repeated specimens 
should be stressed, and the results of a single 
negative specimen should never be accepted as 
conclusive evidence of the absence of disease. 
Specimens submitted in unsterile containers, 
pill boxes, fruit jars, ointment jars, or in paper 
envelopes or on pieces of gauze are utterly use- 
less and M’ill not be examined by the laboratory. 
Pathogenic fungi capable of causing pulmonary 
mycosis are sometimes encountered during cul- 
ture work for tuberculosis. While certain sap- 
rophytic fungi also survive the processing of 
specimens, none of the fungi isolated should be 
casually discarded as harmless contaminants; 
instead, they should be referred to a competent 
mycology laboratory for identification. 
Specimens to be collected for isolation of the 
agent 
a. Sputum, the thick yellowish-green exudate 
from the lungs, and not saliva, should be 
collected in whatever type of sterile con- 
tainer is furnished by the laboratory, and 
in no other. A pinch (about 50 mg.) of 
sodium carbonate added to the container 
will help to suppress the multiplication of 
contaminants. Be sure the sputum is de- 
posited within the container without soiling 
the exterior. Make sure the closure is leak- 
proof and forward the specimen to the 
laboratory in the double mailing container. 
b. Gastric washings, collected in the morning 
on a fasting stomach, should be transported 
to the laboratory as promptly as feasible. 
The more prompt the examination the 
greater the chance of recovering the tubercle 
bacillus. If the specimen is to be sent through 
the mails, some attempt should be made to 
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