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This item is filmed at the reduction ratio checked below/ Ce document est filmi au taux de reduction indiquA ci-dessous. 10X 14X 18X 22X 26X 30X 4 12X 16X 20X 24X 28X 32X Th« copy filmtd h«r« haa baan raproduead thanka to tha ganaroaity of: Medical Library IMcQill University IMontreal Tha imagaa appaaring hara ara tha baat quality poaaibia conaidaring tha condition and iagibility of tha originai copy and in Icaaping with tha fiiming contract apacificationa. Originai copiaa in printad papar covara ara filmad baginning with tha front covar and anding on tha laat paga with a printad or iiiuatratad impraa* tion, or tha bacic covar whan appropriata. Ail othar originai copiaa ara filmad baginning on tha f irat paga with a printad or iiiuatratad impraa- aion. and anding on tha laat paga with a printad or iiiuatratad impraaaion. 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Lan diagrammaa suivants illuatrant la mAthoda. 1 2 3 1 2 3 4 5 1 6 s f L li ^ F tr' I 1 if l\ H -* , w^ ' ■'^>. ■■ >-, i , t X* * ! iifi liL \ [Reprinted from THE Medical News, December lo, 1892.] MEW METHOD FOR THE CULTURE OF DIPH- THERiA-BMC/LLt IN HARD-BOILED EGGS} BY WYATT JOHNSTON, M.D., OF MONTRBAL. All who have had experience in the diagnosis of diphtheria by culture -methods agree in praising their accuracy and promptitude. Unfortunately, the general practitioner, who must feel most of all the need of some accurate method for the prompt diagnosis of doubtful cases, does not seem dis- posed to avail himself of the new process, and the prophecy of Roux and Yersin, that the method would come into general use, appears still to be far from fulfilment. Thinking that the chief obstacle lay in the dif- ficulty of obtaining serum for the culture-medium, M. Sakharof '^ recently suggested a simple plan by which slices of hard-boiled eggs, cut with a steril- ized knife and placed in sterilized tubes, could be made to replace the serum. Of this method I have no personal experience, but should imagine that the main objection would still exist, as the physician might not have test-tubes about him at the time when they were most needed. ^ From the Pathological Laboratory of McGill College. 2 Annales Inst. Pasteur, June, 1892. |iU»#AiW8 m j! '-i 1 1 ' f 1 '(. I have, during the past two months, made use of a method which may be regarded as a modification of Sakharof's, and which does away with the necessity both of test-tubes and the preparation of media before they are actually needed for use. I employ hard-boiled eggs, from which a part of the shell is removed with ordinary forceps, after being tapped so as to break it. In this way shell and shell-membrane can readily be peeled off from one extremity (by selecting the narrow extremity the air-chamber is avoided), leaving a smooth, glistening, moist surface, which offers a most tempt- ing spot for making cultures. These are made, as in the case of serum, by touching the diphtheritic exudation with a sterilized needle and drawing the latter lightly from three to six times across the ex- posed white of the egg. Instead of the regulation platinum needle mounted in a glass rod, I employ either an ordinary needle or a bit of silver suture- wire held in an. artery forceps. To guard the cul- ture against contamination the egg has only to be placed upside down in a common egg-cup ; it can afterward be wrapped in paper and transported, if necessary. The interior of the cup can be sterilized, if desired, by allowing a flame to enter it for a second or two, though I have not found this neces- sary, as the nutrient surface does not come in contact with the inside of the cup. The egg and shell are, of course, both sterilized by the act of boiling. Five minutes* boiling suffices, and if the opera- tion has to be done ** while you wait," the egg can be cooled in a still shorter time by placing it in cold water. Strict attention to aseptic details is iii.'i unnecessary, as the diphtheria-bacillus outstrips in its growth the contaminating organisms likely to lead to confusion. The appearance of the diph- theria-colonies at the expiration of twenty- four hours is the same as when they are grown in serum, but I have found the growth even more rapid, so that a colony is already visible in twelve hours. Confusion with micrococci is, of course, to be guarded against. The reliability of this method seems to be the same as that of the methods of Haffter and E. Roux. I have found one bacillus which attains visible dimensions within the same period, but as this also grew on blood-serum in the manner characteristic of the diphtheria-bacillus, the great value of the method here described is not invalidated by that fact. Although this minor modification of a now well- tried procedure might enable it to be employed by those destitute of laboratory outfits, I do not think it likely that this means of diagnosis will be utilized by physicians not habituated to laboratory methods. It may be of interest to state here that the con- stant temperature of about 35° C, needful to insure the rapid and characteristic growth of the diphtheria- bacillus, can readily be obtained by placing in a cupboard or box with the culture, a large jar or pail of warm water, which is renewed from time to time, thus making an impromptu thermostat. Rw^