Specimens for laboratory examination.

Appx. XXI.

this is impossible, as in the case of outstations, a small portion of a loose
stool should be emulsified, directly after passage, in 30 per cent.
" neutral" glycerin in 0.6 per cent. saline solution, and sent by post.
It is important that the glycerin should not be acid. Constipated
stools are usually worthless for bacteriological examination; therefore
when the condition of the patient permits, the stool resulting after
saline treatment should be forwarded. Proper glass containers
must invariably be used.

       5. Urine .—Specimens of urine should also be sent daily to the
laboratory after the 8th day from onset of the disease. Specimens
should be collected from the first urine passed after waking in
the morning. The first portion should be passed into a separate
receptacle, and about 20 c.c. of the middle portion of the urine
collected into a sterile bottle, and forwarded at once to the
laboratory. Urine from outstations is usually so contaminated
by the time the specimen reaches the laboratory that it is useless
for bacteriological examination. This may be overcome by add-
ing 0.8 c.c. of a 1-10,000 solution of brilliant green to 20 c.c. of
urine (to prepare 1-10,000 brilliant green solution make up a 1-10
solution in distilled water, and add 0.1 c.c. of this solution to 10 c.c.
distilled water). The urine with added brilliant green solution should
be despatched to the laboratory as quickly as possible. Catheter
specimens should be taken when required, but routine daily cathe-
terisation is for obvious reasons undesirable.

       Very careful sealing and packing of receptacles containing blood
fæces or urine are required when they have to be transmitted through
the post. Effective sealing of bottles or tins may be accomplished with
melted paraffin wax or sealing wax. Straw, bran, or some similar
material, never paper, should be used for packing.

SPECIMENS FROM CASES OF SUSPECTED DYSENTERY.

       6. When there is a laboratory in the station send the entire stool
whenever possible and note that the specimen should be sent as early
in the disease and as soon after passage as possible. The longer the
delay the less chance of a positive diagnosis.

       7. Bacillary dysentery.—Dysentery bacilli die out rapidly in the
stool after passage and are only isolated as a rule in the early stages
of the disease i.e., during the first three days. Every endeavour
should therefore be made to ensure that the specimen is sent to the
laboratory directly the patient comes under observation and without
any delay after passage. When the specimen cannot reach the labora-
tory within two hours of being passed, a portion of the mucus should
be placed as soon as possible in 30 per cent. neutral-glycerin in 0.6
per cent. saline and forwarded to the laboratory. It is mast important
that neutral glycerin only should be used. The glycerin solution should
be tested with litmus paper from time to time and neutralised
if necessary.

       A portion of mucus spread on a glass slide and allowed to dry
should also be forwarded from every case for a laboratory examination

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