336 EXAMINATION OF SPUTUM 



plates of plain agar and 3 % salt agar at the same time. An ordinary smear stained 

 with carbol thionin, however, practically makes a diagnosis. 



Pneumococci, M. catarrhalis, and Friedlander's bacillus in sputum are best 

 demonstrated by Gram's method of staining. 



The distinct capsule staining of the pneumococci in a Gram preparation of 

 sputum from a suspected case of pneumonia is of value in diagnosis. 



The finding of the ray fungus (D. bovis) in sputum gives the diagnosis of actino- 

 mycosis. Streptothrix infections of lungs have been confused with tuberculosis. 



Moulds, especially Aspergilli, may be found in sputum. Species of Mucor, 

 Cryptococcus, and Endomyces have also been reported. 



Amoebae from liver abscess rupturing into the lung may be found. Very impor- 

 tant pulmonary infections are those with Paragonimus westermanii. This is recog- 

 nized by the presence of operculated eggs in the sputum. 



A fluke, F. gigantea, was once found in sputum. 



Hydatid cysts, either of the lung or of the liver, rupturing into the lung, may be 

 recognized by the presence of echinococcus hooklets. The material is bile-stained 

 if from the liver. 



Strongylus apri has been reported once from the lungs and embryos might be 

 found in the sputum. In pulmonary bilharziosis Schistosoma eggs may be found in 

 the sputum. 



The test for ALBUMEN IN THE SPUTUM is of value in the diagnosis of pulmonary 

 tuberculosis. 



About 10 c.c. of fresh sputum as pure as possible from saliva is mixed with an 

 equal quantity of water and 2 c.c. of a 3% solution of acetic acid to remove mucin. 

 After filtering the filtrate is tested for albumin. The test is obtained also in 

 pneumonia and pleurisy with effusion. 



