106 APPLIED BACTERIOLOGY FOR NURSES 



extensive inflammation of the lungs results. If the inflam- 

 mation involves an entire lobe or more it is spoken of as 

 a lobar pneumonia; when it is scattered throughout the 

 king it is called a bronchopneumonia. 



In pneumonia there is a marked pouring-out into the 

 air spaces of leukocytes, serum, and fibrin. Mixed with 

 this are degenerated epithelial cells from the air spaces, 

 red blood-cells, pneumococci, and cell debris. The affected 

 lobe becomes almost solid and may be compared to a 

 sponge which has been saturated with pus. There is much 

 absorption of poison from all this material, hence the high 

 fever, delirium, rapid pulse, etc. If the patient recovers 

 the lung gradually resumes its normal condition, the exu- 

 date being absorbed and carried off by the scavenger cells 

 of the body (white blood-cells) . Some of it, to be sure, is 

 expelled by coughing. 



In pneumonia the pneumococci are found in enormous 

 numbers in the sputum; in otitis media, in the pus dis- 

 charged from the ear; in rhinitis it is in the nasal secre- 

 tion; in tonsillitis, in the exudate covering the tonsils; 

 in conjunctivitis and keratitis, in the mucopurulent 

 secretion of the eye. 



We sec, therefore, that a great many different sources 

 of infection must be guarded against. So far as the care 

 of pneumonia patients is concerned, all the sputum 

 should be carefully disinfected, and care should be taken 

 that, in coughing, particles of sputum are not sprayed 

 into the air. In crowded rooms the inhalation of such 

 moist spray particles by others is undoubtedly a com- 

 mon source of infection. Patients suffering from pneu- 

 monia arfe often too ill to prevent their soiling their 

 lips, face, and hands with sputum, and the nurse should, 



