On the other hand the examination of the intestinal discharges plays a much more important part in the diseases of nutrition of in fants, than in older children, and also, on account of its technique, it is simpler and better adapted to general use.
Raudnitz, who has done thorough work on this subject, has devised a very convenient reagent-case, which I have found very useful in a form somewhat modified to conform to modern progress. This contains in drop bottles with ground glass stoppers, the following reagents: (1: Distilled water, for moistening the preparations. (2) A 5 per cent. solution of acetic acid, which dissolves triple phosphate crystals and ealeium carbonate with gas formation, dissolves Charcot-liciden crystals and fatty erystals, but does not dissolve oxalate. It also makes the intestinal mucus stringy, and causes the nuclei of leueocytes, epithelium, and so forth to stand out more clearly. (3) A 20 per cent. sodium hy drate solution, which dissolves the fatty acid needles with the formation of soap, and clears up the albuminous substances. (4) 95 per cent. alcohol, which dissolves the fatty; soap, partially dissolves the free fats and fatty acid needles, and is used in making the staining and deeolor izing fluids. (5) Ether, which dissolves fats, fatty aeids, cholesterin crystals, and free bile-pigments. (6) 5 per cent. sulphuric acid, which shows the presence of calcium through the formation of calcium sulphate crystals, dissolves calcium oxalate, destroys fatty soaps, and stains the cholesterin crystals a violet-red. (7) Fuming nitric acid, for Gmeliu's test for bilirubin and its salts. Lugol's solution (iodine 1. potassium iodide 2. distilled water 300.), for the Weigert-E,scherieh stain, and for eoloring starch and iodophilie bacteria, and also cellulose ; the former become blue, the latter becomes yellowish brown. (9) A filtered concentrated aqueous solution of methylene blue, for staining bacteria and cell-nuelei. (10) A 2.5 per cent. solution of gentian violet in water, boiled for half an hour and filtered; for Escherich's modification of Wcigert's staining method. 111) A mixture of two parts absolute alco hol and three parts aniline oil. (12) Aniline and xylol in equal parts.
(13) Pure xylol, all three for the Eseherich-Weigert stain. (14) Con eentrated alcoholic solution of fuchsin diluted one half with absolute alcohol, as a contrast stain in the Escherich-Weigert method. (15) Alcoholie tincture of alcanna, which stains fat red.
By means of these reagents, a complete examination of fresh stools for the various food ingredients and the residue of digestion, can be carried out. The modification of Weigert's staining method isecommended by Escherich is used for baeteria. It is performed in the following way:— The specimen is spread on the slide, dried, and fixed in the usual way, and is then flooded with a mixture consisting of the gentian violet solution Si parts, and the alcoholic aniline solution parts. This is allowed to remain 2 seconds, and then absorbed with filter paper. Next the iodine and iodide of potash solution is dropped on for a moment, and at once absorbed, after which the aniline-xylol solution is dropped on continuously until no more stain comes off the slide. Then xylol is applied,-and finally, the fuehsin solution is allowed to run over the slide for an instant, and is freely washed off with water. The slide is then dried, and examined, either direetly, or after the application of a cover-glass. I can most highly recommend this proeess, whieh offers a very significant picture in the study of the bacteria of the stools. It is especially adapted to tracing the behavior of the intestinal flora under the influence of various diatetic and therapeutic measures.
In the cultural examination much depends upon the seleetion of a fresh specimen. Either a sterilized lead tube (Escherich), or a Nelaton catheter, in the opening of which sufficient material collects, (Epstein), may be inserted into the anus, or else the freshly passed feces may be taken up with sterile gauze (Flexner-Holt). Other or ganisms are so easily overgrown by the exuberant development of the bacterium coli communis on the ordinary culture media, that a marked dilution of the spechnen to be examined by the use of numerous plate cultures is desirable. Besides the usual methods, anaerobic cultivation should always be employed.