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THE STAINING OF TUBERCLE BACILLI.
938
governor
its behalf. Mr. Horton-Smith was a life of the three hospitals mentioned above, and also of St. Mary’s and the Westminster Hospitals. He took the keenest interest in surgery, and during the later years of his life was such a regular attendant at the lectures at the Royal College of Surgeons as to be known there as "our legal dangerous operation. member." There were many doctors among his THE HEALTH OF TROOPS IN INDIA. wide circle of personal friends and his loss will be felt in hospital circles. A White Paperrecently issued, dealing with the medical arrangements for troops on the NorthWestern Frontier, contains the replies made by the THE STAINING OF TUBERCLE BACILLI. Government of India to criticisms in the House of ’ THE most delicate method for demonstrating the Commons and the British public press. Many of of Koch’s bacillus by staining is that the allegations are categorically denied, but in such on decolorisation by acids. Some acids, based a way as to leave the impression that the Governviolent an the exercise too mineral, especially ment of India has concentrated on some exaggeraif prolonged; so that, in a sputum action, especially tion or inaccuracy, leaving the spirit of the accusation unanswered. A number of admitted abuses which contains few bacilli, the employment of them when in excess of the limit of the acid are explained on various political grounds. For may vitiate the result of the examina. instance, the requisition of certain streams owned resistance The acids employed are glacial tion. by an Afghan tribe, recommended by the military acetic, formic, oxalic,usually tartaric and lactic, with citric, authorities in 1916 and 1917, was not carried out by of the the excessive decolorisa. object minimising the Government for fear of local disturbances at an tion which occurs when mineral acids are used, awkward time. Whatever the reason, however, it is and they have, moreover, the advantage of differensurely bad generalship to send troops to a region tiating the tubercle bacilli from para-tubercle where the water-supply is admittedly inadequate, which are acid-fast in less degree. Professor bacilli, and the connexion of the Kohat cholera epidemic Antonio Gasbarini, of the University of Pavia,’ with the water shortage is not denied. It is is of opinion that the best results are obtained by difficult from a perusal of the correspondence to the use of lactic acid as a decolorant. His judge to what extent the acknowledged deficiency is to treat the slide, the smear having technique been prein stores, and in medical staff
kidneys
were
unaffected, though the
ureteral
orifices were bathed for months in faecal fluid. However rare syphilitic recto-vesical perforation may be, it is necessary to bear the possibility in mind in order to avoid mistaking it for cancer of the rectum and the performance of a useless and -
keenly
presence
transport, hospital dried over the flame, with Ziehl’s carbol. due to lack of foresight, and to what extent viously fuchsin for a few minutes, and then immerse it withto circumstances beyond the control of the Governout washing in a 2 to 3 per cent. alcoholic solution of ment of India. The most encouraging piece of This solution is prepared by information in the White Paper is the announce- lacto-methylene-blue. making a mixture of an excess of was
methylene-blue
ment of the visit to India of Major-General Sir R. Havelock Charles, Medical Adviser to the Secretary of State. Sir Havelock Charles will discuss with local medical authorities-and we hope also with the rank and file of the profession-such matters as recruiting for the Indian Medical Service, the provision made for medical and sanitary training and research, and the organisation of the medical women, on the importance of which we recently commented. The visit should help to improve the mutual understanding on big medical questions between the Secretary of State for India and the Viceroy. We trust that future correspondence may indicate a desire on both sides to improve conditions rather than a facility in
with lactic acid 40 c.cm. and water 160 c.cm., with four parts alcohol of 95 per cent. The lacto-blue has a simultaneous decolorising and recolorising effect extending to all parts of the preparation, which is then washed in running water, dried, and mounted. To demonstrate the tubercle bacillus in urine the smear is treated with a 5-10 per cent. solution of soda with 5 per cent. alcohol in order to dissolve the fatty matter of the smegma bacillus which renders this micro-organism acid-fast. Koch’s bacillus remains coloured red and easily distinguished from the associated flora and cytological elements which assume a clear, pale-blue tint not easily attainable with other methods. This method Professor Gasbarini asserts is much more reliable repartee. than those in which mineral acids are employed, and he has been able to demonstrate the presence of THE LATE MR. R. H. HORTON-SMITH, K.C. tubercle bacilli in sputum, urine, and faeces in THE recent death, at an advanced age, of Mr. doubtful cases where Ziehl’s method had given Richard Horton Horton-Smith, K.C., removes a negative results. Since the acid-fast property of well-known barrister whose professional work Koch’s bacillus is not deranged by the action of the ended with the last century, and who since his lactic acid it is evident that the method may retirement has devoted himself to the furtherance reveal its presence even when existing in small of political, artistic, and philanthropic causes. A numbers and without previous centrifugalisation. well-known classic, his interests included music, Moreover, it enables a differentiation to be made Freemasonry, and hospital administration. His between tubercle bacilli and the ordinary pseudodirect association with hospitals dates from 1898, tubercle, and by the same means the smegma when he joined the committee of King’s College bacillus is decolorised by the lacto-blue in 20 to 25 Hospital, and he became later chairman of Uni- minutes, while that of tubercle is still well defined. versity College Hospital. In 1904 he was elected The sharp staining of other non-acid-fast bacilli a member of the committee of the Brompton facilitates the investigation of the associated for Consumption and Diseases of the micro-organisms which are of considerable imporHospital He was also chairman of the Public tance in tuberculous infections, and lends itself Chest. Dispensary in Drury Lane, and just before his death to the study of tuberculosis in the tissues received an address of gratitude for his labours on themselves. ---
1
H.M. Stationery Office.
Cmd. 398.
Price 3d.
1
Il
Policlinico, Practical Section, July 13th, 1919.
governor
its behalf. Mr. Horton-Smith was a life of the three hospitals mentioned above, and also of St. Mary’s and the Westminster Hospitals. He took the keenest interest in surgery, and during the later years of his life was such a regular attendant at the lectures at the Royal College of Surgeons as to be known there as "our legal dangerous operation. member." There were many doctors among his THE HEALTH OF TROOPS IN INDIA. wide circle of personal friends and his loss will be felt in hospital circles. A White Paperrecently issued, dealing with the medical arrangements for troops on the NorthWestern Frontier, contains the replies made by the THE STAINING OF TUBERCLE BACILLI. Government of India to criticisms in the House of ’ THE most delicate method for demonstrating the Commons and the British public press. Many of of Koch’s bacillus by staining is that the allegations are categorically denied, but in such on decolorisation by acids. Some acids, based a way as to leave the impression that the Governviolent an the exercise too mineral, especially ment of India has concentrated on some exaggeraif prolonged; so that, in a sputum action, especially tion or inaccuracy, leaving the spirit of the accusation unanswered. A number of admitted abuses which contains few bacilli, the employment of them when in excess of the limit of the acid are explained on various political grounds. For may vitiate the result of the examina. instance, the requisition of certain streams owned resistance The acids employed are glacial tion. by an Afghan tribe, recommended by the military acetic, formic, oxalic,usually tartaric and lactic, with citric, authorities in 1916 and 1917, was not carried out by of the the excessive decolorisa. object minimising the Government for fear of local disturbances at an tion which occurs when mineral acids are used, awkward time. Whatever the reason, however, it is and they have, moreover, the advantage of differensurely bad generalship to send troops to a region tiating the tubercle bacilli from para-tubercle where the water-supply is admittedly inadequate, which are acid-fast in less degree. Professor bacilli, and the connexion of the Kohat cholera epidemic Antonio Gasbarini, of the University of Pavia,’ with the water shortage is not denied. It is is of opinion that the best results are obtained by difficult from a perusal of the correspondence to the use of lactic acid as a decolorant. His judge to what extent the acknowledged deficiency is to treat the slide, the smear having technique been prein stores, and in medical staff
kidneys
were
unaffected, though the
ureteral
orifices were bathed for months in faecal fluid. However rare syphilitic recto-vesical perforation may be, it is necessary to bear the possibility in mind in order to avoid mistaking it for cancer of the rectum and the performance of a useless and -
keenly
presence
transport, hospital dried over the flame, with Ziehl’s carbol. due to lack of foresight, and to what extent viously fuchsin for a few minutes, and then immerse it withto circumstances beyond the control of the Governout washing in a 2 to 3 per cent. alcoholic solution of ment of India. The most encouraging piece of This solution is prepared by information in the White Paper is the announce- lacto-methylene-blue. making a mixture of an excess of was
methylene-blue
ment of the visit to India of Major-General Sir R. Havelock Charles, Medical Adviser to the Secretary of State. Sir Havelock Charles will discuss with local medical authorities-and we hope also with the rank and file of the profession-such matters as recruiting for the Indian Medical Service, the provision made for medical and sanitary training and research, and the organisation of the medical women, on the importance of which we recently commented. The visit should help to improve the mutual understanding on big medical questions between the Secretary of State for India and the Viceroy. We trust that future correspondence may indicate a desire on both sides to improve conditions rather than a facility in
with lactic acid 40 c.cm. and water 160 c.cm., with four parts alcohol of 95 per cent. The lacto-blue has a simultaneous decolorising and recolorising effect extending to all parts of the preparation, which is then washed in running water, dried, and mounted. To demonstrate the tubercle bacillus in urine the smear is treated with a 5-10 per cent. solution of soda with 5 per cent. alcohol in order to dissolve the fatty matter of the smegma bacillus which renders this micro-organism acid-fast. Koch’s bacillus remains coloured red and easily distinguished from the associated flora and cytological elements which assume a clear, pale-blue tint not easily attainable with other methods. This method Professor Gasbarini asserts is much more reliable repartee. than those in which mineral acids are employed, and he has been able to demonstrate the presence of THE LATE MR. R. H. HORTON-SMITH, K.C. tubercle bacilli in sputum, urine, and faeces in THE recent death, at an advanced age, of Mr. doubtful cases where Ziehl’s method had given Richard Horton Horton-Smith, K.C., removes a negative results. Since the acid-fast property of well-known barrister whose professional work Koch’s bacillus is not deranged by the action of the ended with the last century, and who since his lactic acid it is evident that the method may retirement has devoted himself to the furtherance reveal its presence even when existing in small of political, artistic, and philanthropic causes. A numbers and without previous centrifugalisation. well-known classic, his interests included music, Moreover, it enables a differentiation to be made Freemasonry, and hospital administration. His between tubercle bacilli and the ordinary pseudodirect association with hospitals dates from 1898, tubercle, and by the same means the smegma when he joined the committee of King’s College bacillus is decolorised by the lacto-blue in 20 to 25 Hospital, and he became later chairman of Uni- minutes, while that of tubercle is still well defined. versity College Hospital. In 1904 he was elected The sharp staining of other non-acid-fast bacilli a member of the committee of the Brompton facilitates the investigation of the associated for Consumption and Diseases of the micro-organisms which are of considerable imporHospital He was also chairman of the Public tance in tuberculous infections, and lends itself Chest. Dispensary in Drury Lane, and just before his death to the study of tuberculosis in the tissues received an address of gratitude for his labours on themselves. ---
1
H.M. Stationery Office.
Cmd. 398.
Price 3d.
1
Il
Policlinico, Practical Section, July 13th, 1919.