A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
By this method organisms which stain by Gram's method (staphylococci,
streptococci, pneumococci, etc.) are purplish-black; organisms which
decolorize by Gram's method (bacilli of Friedländer, influenza
bacilli, etc.) are blue; capsules are pink; nuclei of all cells are
blue; and granules of eosinophilic cells are bright red.
_Anilin-gentian-violet_.--Ehrlich's formula is the one generally used,
but this keeps only a few weeks. Stirling's solution, which keeps much
better and seems to give equal results, is as follows: gentian-violet,
5 gm.; alcohol, 10 c.c.; anilin oil, 2 c.c.; water, 88 c.c.
_Gram's Iodin Solution_.--Iodin, 1 gm.; potassium iodid, 2 gm.; water,
300 c.c.
_Löffler's alkaline methylene-blue_ is a very generally useful stain
for bacteria. It is composed of 30 parts of a saturated alcoholic
solution of methylene-blue and 100 parts of a 1:10,000 aqueous
solution of caustic potash. It keeps indefinitely.
* * * * *
(4) Bacillus of Friedländer (Bacillus mucosus capsulatus).--In a small
percentage of cases of pneumonia, this organism is found alone or in
company with the pneumococcus. Its pathologic significance is
uncertain. It is often present in the respiratory tract under normal
conditions. Friedländer's bacilli are non-motile, {39} encapsulated
rods, sometimes arranged in short chains (Fig. 10). Very short
individuals in pairs closely resemble pneumococci, from which they are
distinguished by the fact that they are Gram-decolorizing.
[Illustration: FIG. 10.--Friedländer's bacillus in pus from pulmonary
abscess (obj. one-twelfth) (Boston).]
(5) Bacillus of Influenza.--This is the etiologic factor in true
influenza. It is present, often in large numbers, in the nasal and
bronchial secretions, and is also found in the local lesions following
influenza. Chronic infection by influenza bacilli may be mistaken
clinically for tuberculosis, and they should be searched for in all
cases of obstinate chronic bronchitis.
Their recognition depends upon the facts that they are extremely small
bacilli; that most of them lie within the pus-cells; that their ends
stain more deeply than their centers, sometimes giving the appearance
of minute diplococci; and that they are decolorized by Gram's method
of staining (Fig. 11).
They are stained blue in Gabbet's method for tubercle bacilli, but are
more certainly recognized by Smith's method or by Gram's method,
followed by Bismarck brown or fuchsin, as follows:
* * * * *
Gram's Method.--(1) Make smears, dry und fix by heat.
(2) Apply anilin-gentian-violet two to five minutes.
(3) Wash with water.
(4) Apply Gram's iodin solution one-half to two minutes.
(5) Wash in alcohol until the purple color ceases to come off.
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