Pulmonary tuberculosis and its complications, with special reference to diagnosis and treatment : for general practitioners and students / by Sherman G. Bonney ... With 189 original illustrations, including 20 in colors and 60 X-ray photographs.

  • Bonney, Sherman G. (Sherman Grant), 1864-1942.
Date:
1908
Catalogue details

Licence: In copyright

Credit: Pulmonary tuberculosis and its complications, with special reference to diagnosis and treatment : for general practitioners and students / by Sherman G. Bonney ... With 189 original illustrations, including 20 in colors and 60 X-ray photographs. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    33/842 (page 21)
    cent, alcohol. After washing, the specimen is stained with methylene- blue for about thirty seconds, although no harm results, as a rule, if this is permitted to remain for a considerably longer period. After , washing again with water and drying the specimen usually is mounted in Canada balsam. The retention of the primary stain by the microorganism is of exceed- ing value in the differentiation of the true from the pseudotubercle bacillus. There remain, however, a considerable number of acid-fast bacilli which closely resemble the tubercle bacillus in other respects. For this reason the appellation pseudotubercle bacillus' is usually restricted to bacteria which simulate the appearance of tubercle bacilli and do not yield to acid decolorization. Among the varieties which do not surrender their primary stain upon the employment of acids the smegma bacillus is the most important, as the presence of this micro- organism may lead to unfortunate errors of diagnosis involving to a vast degree the well-being of the patient. In cases susceptible of reasonable doubt a staining in accordance with the ordinary methods must lead to inevitable confusion in the interpretation of results. It is found that ' the smegma bacillus holds its color after a prolonged exposure to absolute alcohol, but yields its stain upon boiling in alcohol. Aronson has shown • that the tubercle bacillus contains wax and fatty acids, on account of which combination the microorganism is acid fast. The smegma bacil- lus, on the other hand, has fat and sebaceous matter in place of wax. This bacillus may be robbed of its fat by boiling in alcohol, which has slight effect upon the wax contained in the tubercle bacillus. Bienstock and Gottstein were able to treat other bacilli with fats, as butter, lanolin, paraffin, and wax, and make them acid fast. By the addition of these ^ substances to several culture-mecUa they were able also to give a degree of acid-fastness to bacilli which otherwise yielded to acid decolorization. Various procedures are employed for the clifferential staining of the true and the smegma bacillus, all based upon the application of the influence of alcohol. The use of inorganic acids is found of no value. Pappen- heim has devised a method which produces a ready decolorization of the smegma bacillus by flucwescein-alcohol. After the production of the primary stain the preparations are immersed several times in Pappen- heim's solution, which consists of one part of coi'allin in 100 parts of absolute alcohol, to which methylene-blue is added to saturation and diluted with 20 parts of glycerin (Simon). As a practical matter, error in the differentiation of the bacilli may take place principally in connec- tion with genito-urinary tuberculosis. It is now the custom of clinicians and surgeons to insist upon catheterized specimens of urine before sub- mission to bacteriologists for examination. This plan obviates to a degree the danger of confusing the tubercle bacillus with the smegma microorganism. The lepra bacillus is of but slight interest to practitioners in this country. It presents, however, several points of resemblance to the tubercle bacillus, particularly in form and staining reaction. Cornet has referred to the disposition of the lepra bacilli, as pointed out by Bdbes, this feature distinguishing them from the tubercle bacillus. The former are found by preference within the cell and grouped very closely together. The latter are usually without the cells, but if intracellular, do-not arrange themselves in such den,se masses as to obscure the nucleus. He also calls attention to the comparative rapidity with which the lepra