2 5 



NORMAL FORMATION OF MUCUS IN THE AIR-PASSAGES. 



Eosinophile cells are found in the sputum from cases of asthma, and also in 

 the nasal secretion from cases of acute coryza and of nasal polyps. Leukocytes 

 containing hemosiderin are found after capillary hemorrhages in the air-passages. 



The fluid substance of the sputum contains much mucus, derived 

 from the mucous glands and the goblet-cells, also some nuclein and 

 lecithin, and the constituents of the saliva, according to the amount 

 mixed with the sputum. Albumin is found in the sputum only in cases 

 of inflammation of the air-passages; its amount increases with the 

 degree of inflammation. Urea has been found in the sputum in cases 

 of advanced nephritis. 



Pathological. In the presence of catarrhal conditions the sputum is usually 

 at first glairy and slimy (sputa cruda) ; later, it becomes more consistent and 

 yellow (sputa cocta) . 



FIG. 92. Objects Found in the Sputum: i, detritus and dust-particles; 2, pigmented alveolar epithelium; 3, 

 fatty degenerated and partially pigmented alveolar epithelium; 4, alveolar epithelium showing myelin-de- 

 generation; 5, free myelin-forms; 6, 7, desquamated ciliated epithelium, partly changed and deprived of its 

 cilia; 8, squamous epithelium from the mouth; 9, leukocytes; 10, elastic fibers; n, fibrinous cast of a small 

 bronchus; i 2 leptothrix buccalis, together with cocci bacilli, and spirochetae; a, fatty-acid crystals and free 

 fatty granules; b, hematoidin; c, Charcot's crystals; d, cholesterin. 



Under pathological conditions there may be found in the sputa : 



(a) Erythrocytes, always from rupture of a blood-vessel. 



(6) Elastic fibers (10) from destroyed pulmonary alveoli. Usually they occur 

 in small bundles of delicate fibers, which at times suggest the rounded walls of 

 the alveoli by their curved arrangement. Naturally, they always indicate 

 destruction of pulmonary tissue. 



(c) Much more rarely, in the presence of rapid and extensive disintegration 

 of the lungs, there occur larger fragments of pulmonary debris, embracing several 

 alveoli ; likewise small pieces of fibro-cartilage or unstriated muscle-fibers from the 

 small air-passages. 



(d) Colorless coagula of fibrin (n) may be found, and are usually to be recog- 

 nized as casts of the smaller or larger air-passages. They are formed in connection 

 with inflammatory processes in the lungs or bronchi that are attended with a 

 fibrinous exudation into the tubules. They are thus found frequently in cases of 

 pneumonia in adults, in cases of bronchial croup, and also, rarely, in cases of 

 severe influenza. 



