A treatise on the principles and practice of medicine . e inverted without spilling thesputum. In two days it becomesred and rusty (80 per cent, of cases).Later it becomes more fluidity may rarely resultfrom weak heart. Rusty sputum is often absent in children who swallow sputum; in upper-lobe pneu-monia, in which there is less hemorrhage, less consolidation and lesscough to dislodge exudation; and finally in the senile and secondarypneumonias, because of weakness or toxemia. The cause of unusualcolor in the sputum, such as lemon- or brick-color, is unknown; it issometimes o
A treatise on the principles and practice of medicine . e inverted without spilling thesputum. In two days it becomesred and rusty (80 per cent, of cases).Later it becomes more fluidity may rarely resultfrom weak heart. Rusty sputum is often absent in children who swallow sputum; in upper-lobe pneu-monia, in which there is less hemorrhage, less consolidation and lesscough to dislodge exudation; and finally in the senile and secondarypneumonias, because of weakness or toxemia. The cause of unusualcolor in the sputum, such as lemon- or brick-color, is unknown; it issometimes observed in pulmonary edema or incipient gangrene andobscures the prognosis. Safranin color {sputum croceum) indicatesresolution. The rusty sputum is of great diagnostic value—e. g.,in the beginning of the disease or in central pneumonia—and gener-ally is of good import. Fibrin threads or casts of the bronchioles areusually seen between the third and seventh days. On shaking thesputum in water and catching the shreds on a slide, they appear clubbed. Fig. 10.—Fibrinous coagulum from a caseof croupous pneumonia (Bizzozero). PNEUMONIA 67 at their alveolar ends; they are also found in tuberculosis and fibrinousbronchitis. They consist of fibrin, white cells, fatty cells and sputum contains blood cells, epithelia and pneumococci, foundfirst by Wolff in sputum and by Weichselbaum in the lung. (6) Lung Pathology.—Laennec, the first to differentiate pneumoniafrom pleurisy (1819), described three stages: (a) The stage of hyper-emia is very exceptionally observed unless the subject dies in twenty-four to thirty-six hours, although hyperemia may be seen at theedges of the consolidation where the pneumonia is beginning toextend. The lung crepitates less and floats; it is red, tears readily,since it has lost its elasticity, and on section exudes a serosanguineousfluid. Under the microscope, congestion, serum and diplococci in thealveoli are observed. The alveolar epith
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