. A manual of clinical diagnosis by means of microscopical and chemical methods, for students, hospital physicians, and practitioners . vi. p. 562. 280 THE SPUTUM. less appearance, and the fact that at times fine concentric striationscan be detected. These forms may be round, but more often theyare irregular. At times fatty, myelin, and pigment-granules maybe seen in one and the same cell. Possibly they are derived fromthe pulmonary alveoli, but this is still an open question. Chemi-cally, the myelin droplets have been shown to contain a considerableamount of protagon, besides traces of lecith
. A manual of clinical diagnosis by means of microscopical and chemical methods, for students, hospital physicians, and practitioners . vi. p. 562. 280 THE SPUTUM. less appearance, and the fact that at times fine concentric striationscan be detected. These forms may be round, but more often theyare irregular. At times fatty, myelin, and pigment-granules maybe seen in one and the same cell. Possibly they are derived fromthe pulmonary alveoli, but this is still an open question. Chemi-cally, the myelin droplets have been shown to contain a considerableamount of protagon, besides traces of lecithin and Liver-cells may at times be observed in the sputa in cases of liver-abscess, and are easily recognized by their characteristic form. Elastic Tissue.—Much more important from a clinical stand-point are the elastic fibres and shreds of elastic tissue which maybe found in sputa. They vary much in length and breadth, andare provided with a double, undulating contour; they are usuallycurled at their ends. Very often they exhibit an alveolar arrange-ment (Fig. 74), which at once determines their origin. Fig. Elastic fibres in the sputum. (Eye-piece III., objective 8 A, Reichert.) (v. Jaksch.) Whenever present, elastic tissue is an absolute indication that adestructive process is going on in the lungs. It is found in casesof abscess of the lungs, bronchiectasis, occasionally in pneumonia,and, most important of all, in phthisis. In gangrene of the lungelastic tissue is usually not found ; this is probably owing to itsdestruction by a ferment, as suggested by Traube. In everv case it is necessary to determine whether the elastictissue may not be owing to the presence of animal food in thesputum, and it may, hence, be stated as a rule that it can onlybe regarded as absolutely characteristic when showing the alveolararrangement. In order to demonstrate the presence of elastic tissue in the 1 A. Schmidt, Ueber Herkunft u. chem. Natur d. Myelinformen d. Sputums,B
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