THE MICROSCOPE IN DIAGNOSIS. 317 



nasal or respiratory passages may be seen, and perhaps 

 molecules of fat, pus-globules, blood, and " inflammatory 

 corpuscles." In phthisis the decaying lung may be early 

 detected by the fibres of elastic tissue from the walls of the 

 pulmonary vesicles. The sputa should be first liquefied 

 by boiling a little while in an equal bulk of caustic soda, 

 then allowed to settle in a conical glass, when a small 

 quantity may be removed to a glass slide, covered with 

 thin glass, and placed under the microscope. 



The occurrence of fungi in sputum is to be expected 

 whenever there is decay. The Leptothrix buccalis, one 

 form of penicillium, is common on old epithelial scales of 

 the mouth, and in the latter stages of phthisis the sputa 

 will often show fungi in various forms of development. 



In catarrhal pneumonia we may find fibrinous casts of 

 the alveoli of the lungs and epithelial elements, chloride 

 of sodium, etc. Hydatids are sometimes expectorated in 

 sputum, the appearance of the booklets of the echinococci 

 being quite characteristic. Scales of cholesterin and 

 blood-crystals may also occur, as well as calcareous con- 

 cretions and dark melanotic masses. 



Richardson states that associated matters may indicate 

 the source of blood in sputum. Thus associated salivary 

 corpuscles might show haemorrhage within the mouth, 

 amoeboid leucocytes, haemorrhage in the fauces or trachea, 

 starch -granules and particles of food, hsematemesis, and 

 coagulated casts, pulmonary hsemorrhage. 



VI. VOMITED MATTERS. 



Microscopic examination of vomited matters reveals 

 muscular fibres, starch-granules, oil-globules, and shreds 

 of vegetable tissue, according to the diet of the patient. 

 Crystals of margarin, etc., are often seen. Blood, pus, 

 etc., may be recognized if their structure be not destroyed 

 by the digestive fluids. 



Isolated specimens should be picked out with forceps 



