SECRETIONS AND EXCRETIONS. 227 



he can observe the presence of bacteria, animal para- 

 sites or their eggs, and the various other constituents 

 invisible to the unaided eye. 



Attention should always be given to the 

 Amount, amount of sputum expectorated in the 



twenty-four hours, since only in this way 

 can an increase or decrease be definitely determined. 

 A daily record should be kept of the quantity, other- 

 wise in the rush of other work valuable information 

 may be lost. Especially important is a knowledge of the 

 amount of expectoration in case of haemorrhage, or of a 

 sudden large increase, as may occur when an hepatic 

 abscess ruptures into the lungs. The twenty-four 

 hours' quantity should be measured for the reason that 

 many patients (e.g., pulmonary tuberculosis, bron- 

 chiestasis) expectorate chiefly only during one or two 

 hours in the twenty-four, so that if the amount expelled 

 at this time is not taken into account, a report of a scanty 

 expectoration might be made. 



Consistence of a sputum is another charac- 

 CoNsisTENCE. tcristic of importance; it may be thin and 



watery (serous), or so heavy and tenacious 

 that the vessel may be inverted without spilling its con- 

 tents (mucoid). Mucoid sputum is seen most charac- 

 teristically during the stationary period of pneumonia. 

 Between these two extremes there may be various de- 

 grees of consistency, or the sputum may consist of both 

 elements distinctly discernible (muco-serous). Thus, 



