274 



THE SPUTUM. 



(Fig. 115), more rarely alveolar epithelium and ciliated epithelium (7) 

 from the respiratory passages, The epithelial cells are often altered, 

 having undergone maceration or other changes. Thus some cells may 

 have lost their cilia (6). 



The epithelium of the alveoli (2) is squamous epithelium, the cells being 2 to 4 

 times the breadth of a colourless blood-corpuscle. These cells occur chiefly in the 

 morning sputum in individuals over 30 years of age. In younger persons their 

 presence indicates a pathological condition of the pulmonary parenchyma 

 (Guttman, H. Schmidt, and Bizzozero). They often undergo fatty degeneration, 

 and they may contain pigment granules (3); or, they may present the appearance 

 of what Buhl has called "myelin degenerated cells;" i.e., cells filled with clear 

 refractive drops of various sizes, some colourless, others coloured particles, the 

 latter having been absorbed (4). Mucin in the form of myelin drops (5) is 

 always present in sputum. 



2. Lymphoid cells (9) are to be regarded as colourless blood- corpuscles 

 which have wandered out of the blood-vessels; they are most numerous 

 in yellow sputum, and less numerous in the clear, mucus-like excretion. 

 The lymph-cells often present alterations in their characters ; they may 

 be shrivelled up, fatty, or present a granular appearance. 



Fig. 115. 



Various objects found in sputum 1, Detritus and particles of dust ; 2, alveolar 

 epithelium with pigment; 3, fatty and partly pigmented alveolar epithelium; 

 4, alveolar epithelium containing myelin-f orms ; 5, free myelin-forms ; 6, 7, 

 ciliated epithelium, some changed, others without cilia; 8, squamous epithelium 

 from the mouth; 9, leucocytes; 10, elastic fibres; 11, fibrin-cast of a small 

 bronchus; 12, leptothrix buccalis with cocci, bacteria, and spirochseti; a, 

 fatty acid crystals and free fatty granules; b, hsematoidin; c, Charcot's 

 crystals; d, Cholesterin. 



