102 The Microscope. 



satisfactory results, that the practising physician is many times 

 repaid for the trouble. Such an examination is rarely made ex- 

 cept when looking for abnormal ingredients to assist in confirming 

 or correcting a diagnosis. The presence of tubercle bacilli or elas- 

 tic tissue in the sputum is often the first sign of dangerous pul- 

 monary trouble, and this early sign, detected often long before 

 physical signs point to the disease, enable us to act promptly, 

 and at times to avert or cure a disease so frequenth' considered 

 incurable. 



In addition to these two abnormal ingredients of the sputum 

 there are found, as normal ingredients, those round or oval cells^ 

 perhaps, in some cases, cast off alveolar epithelium or else 

 leucocytes. These cells rarely fail in normal expectoration. They 

 are a little larger than the lymph cells, and are brought up by 

 the ciliated epithelium, and cast out in the expectoration. 

 When examined under proper conditions, they show amoeboid 

 movements. In health, they seem to have no particular function^ 

 but in certain diseases, they are of great use. 



Their function has been brought to my attention recently in 

 stud3ang several cases of what I thought was pulmonary con- 

 sumption. The physical signs not giving sufficient information, 

 a history of the j^atients' occupation and former life and also an 

 examination of their sputum threw light on the subject. Case I. 

 was a worker in a slate quarry. Case II. a stoker who had 

 worked for from thirty to forty years in the cellar of a factory, 

 putting on coal, and living in an atmosphere of coal and ash- 

 dust. Case III. was a man who had worked for more than 

 twenty years in an iron foundry, where his principal occupation 

 had been at the lathe, turning articles of iron and leaning over 

 his work breathing in the iron dust. Case IV. was a man who 

 Avorked for several years in what he called a " clay factory," and 

 giving that up because he could not stand the dust}^ atmosphere 

 which he said made liim cough and short of breath, he sought 

 for .some time other work and finally, in despair, took a position 

 in the B. and 0. R. R., cleaning out furnaces, where he is again 

 exposed to a dusty atmosphere but of a different character. The 

 expectoration of each case was slightly colored according to the 

 character of dust inhaled, and Case II. still continues at times 

 to expectorate dark and even black sputum, although he gave 

 up his position one year ago. An examination of specimens of 



