Since quinine has a destructive effect upon malaria parasite, films prepared after the administration of this drug may not show the organisms in numbers sufficient to be detected, and the microscopic diagnosis may be misleading. Fill out malaria slip (No. 3). Name of patient Residence of patient SLIP NO. 3-Malaria. Name of attending physician Address of attending physician Date of preparation and relation in time to chill. Any quinine or other medicine administered before preparation of film? In inflamatory conditions of the throat it is of the utmost importance that an early microscopic examination should be made in order to determine whether the latter is due to the presence of the diphtheria bacilli. Cultures should, therefore, be made at the earliest possible moment, and forwarded to the laboratory with greatest possible speed. For the diagnosis of diphtheria, tubes sterilized cotton swabs can be obtained from the laboratory, or from a depot. In cases where it is possible to get a good view of the throat depress the tongue, straighten the wire without touching the cotton swab, and rub it gently against any visible exudate. In other cases, avoiding the tongue, pass the swab far back and rub it freely against the mucous membrane of the pharnyx and tonsils. Bend wire to original position and replace the swab in tube, plug tube, and for ward to the laboratory, together with slip No. 4, properly filled out. The investigations of Bigg and Park, of New York, have shown that out of 405 cases of diphtheria examined by them virulent bacilli were found in the throat of one-fourth of all the cases seven days after the complete disappearance of all membrane, and in three cases five weeks. Physicians are, therefore, urged to hold their patients in quarantine until cultures made from the throat show the entire absence of the diphtheria organism. Cultures should, therefore, be inade and sent to the laboratory for examination at intervals during convalesc.nce. Reports on all primary examinations of diphtheria will be forwarded by telephone or telegraph at the physician's expense, about twenty-four hours after the receipt of the cultures at the laboratory. SLIP No. 4-BACTERIOLOGICAL DEPARTMENT, LOUISIANA STATE BOARD OF HEALTH, NEW ORLEANS, LA. Was any antiseptic used within two hours of taking specimen?. Clinical diagnosis Shall result be communicated by telegraph at your expense?. DIRECTIONS FOR MAKING CULTURES IN SUSPECTED CASES OF DIPHTHERIA. The patient should be placed in the best light attainable, and if a child, properly held. In cases where it is possible to get a good view of the throat, depress the tongue and rub the cotton swab gently, but freely against any visible pseudo membrane or exudate. In other cases, including those in which the exudate is confined to the larnyx, open the mouth and pass the swab back till it reaches the pharynx, and then rub it freely against the mucous membrane. Replace the swab in its tube. The diagnosis will be ready by noon the following day, and the report sent to the address given by the physician. As recent investigations have demonstrated the presence of the bacillus in some cases for many days after the disappearance of the false membranes, it is therefore desirable in all cases of true diph theria to make second inoculation before disinfection. N. B. Make the culture when possible before application to throat. When this is not possible make the culture at least two hours after application. All communications on this subject should be addressed to Telephone 734 P. E. ARCHINARD, M. D., Bacteriologist, Tulane Ave. and Liberty St. URINE EXAMINATION. Urine should be examined either when freshly voided, or, as when sent to the laboratory, some preservative should be added to prevent fermentation. Old fermented urine is absolutely worthless for exami nation. To preserve the urine use either of the following: 2 or 3 drops of formalin to the 5 ozs. of urine. 10 or 16 grains of thymol to the 4 ozs. of urine. Urine should be forwarded in absolutely clean 4-ounce bottles and enclosed in a wooden mailing case to be found at the supply stations. For tests of albumen it is best to send urine voided after meals, where a quantitative estimation of urinary solids is desired the samples should represent the urine voided and measured for twenty-four hours. Fill in slip No. 5. SLIP No. 5-BACTERIOLOGICAL DEPARTMENT, LOUISIANA STATE BOARD OF HEALTH, NEW ORLEANS, LA. Urine should be examined either when freshly voided, or, as when sent to the Laboratory, some preservative should be added to prevent fermentation. To preserve the urine use either of the following: 2 or 3 drops of formalin to the 4 ozs. of urine. Urine should be forwarded in absolutely clean 4 oz. bottles and enclosed in a wooden mailing box to be found at the supply stations. For tests of albumen it is best to send urine voided after meals. Where a quantitative estimation of urinary solids is desired, the samples should represent the urine voided and measured for twenty-four hours. Fill in slip 5. P. E. ARCHINARD, M. D., Bacteriologist, Tulane Ave. and Liberty St. BACTERIOLOGICAL EXAMINATION OF DRINKING WATER. An eight ounce bottle, together with a good clean cork, are placed in a basin of cold water, which is brought gradually to a boil. The boiling is continued fifteen minutes to thoroughly sterilize both bottle and cork. Grasp the bottle by the base, not by the neck, pump or let water run for some minutes, then fill the bottle, pack on ice and forward by express, prepaid, to the Laboratory. Fill in slip No. 6. N. B. No specimen shall be examined unless prepared according to above directions and appropriate slips filled out. SLIP No. 6-BACTERIOLOGICAL DEPARTMENT, LOUISIANA STATE BOARD OF HEALTH, NEW ORLEANS, LA. BACTERIOLOGICAL EXAMINATION OF DRINKING WATER. Source of water sent Name of sender .. Object of examination N. B.-All packages sent to Laboratory must have express or postoffice charges prepaid. P. E. ARCHINARD, M. D., Bacteriologist, Tulane Ave. and Liberty St. During the years 1906-1907 the following examinations were made for the Louisiana State Board of Health: |