A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
The animals should be killed at the end of six or eight weeks, if they
do not die before that time, and a careful postmortem examination
should be made for the characteristic pearly-gray or yellow tubercles
scattered over the peritoneum and through the abdominal organs,
particularly the spleen, and for caseous inguinal and retroperitoneal
lymph-glands. The tubercles and portions of the caseous glands should
be crushed between two slides, dried, and stained for tubercle
bacilli. The bacilli are difficult to find in the caseous material.
THE MOUTH
Micro-organisms are always present in large numbers. Among these is
_Leptothrix buccalis_ (Fig. 121), which is especially abundant in the
crypts of the tonsils and the {271} tartar of the teeth. The whitish
patches of _pharyngomycosis leptothrica_ are largely composed of these
fungi. They are slender, segmented threads, which generally, but not
always, stain violet with Lugol's solution, and are readily seen with
a one-sixth objective. At times they are observed in the sputum and
stomach fluid. In the former they might be mistaken for elastic
fibers; in the latter, for Boas-Oppler bacilli. In either case, the
reaction with iodin will distinguish them.
[Illustration: FIG. 121.--Gingival deposit (unstained): _a_, Squamous
epithelial cells; _b_, leukocytes; _c_, bacteria; _d_, Leptothrix
buccalis (Jakob).]
Thrush is a disease of the mouth seen most often in children, and
characterized by the presence of white patches upon the mucous
membrane. It is caused by the thrush fungus, _Oïdium albicans_. When a
bit from one of the patches is pressed out between a slide and cover
and examined with a one-sixth objective, the fungus is seen to consist
of a network of branching segmented hyphæ with numerous spores, both
within the hyphæ and in the meshes between them (Fig. 122). The meshes
also contain leukocytes, epithelial cells, and granular débris.
{272} [Illustration: FIG. 122.--Thrush fungus (Oïdium albicans)
(Jakob).]
[Illustration: FIG. 123.--Bacillus diphtheriæ, from culture on
blood-serum. X1000 (Fränkel and Pfeiffer).]
Acute pseudomembranous inflammations, which occur chiefly upon the
tonsils and nasopharynx, are generally caused by the diphtheria
bacillus, but may result from streptococcic infection. In many cases
diphtheria {273} bacilli can be demonstrated in smears made from the
membrane and stained with Löffler's methylene-blue or 2 per cent.
aqueous solution of methyl-green. They are straight or curved rods,
which vary markedly in size and outline, and stain very irregularly
(Fig. 123). A characteristic form is a palely tinted rod with several
deeply stained granules (metachromatic bodies), or with one such
granule at each end. They stain by Gram's method. It is generally
necessary, and always safer, to make a culture upon blood-serum,
incubate for twelve hours, and examine smears from the growth.
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