A Manual of Clinical DiagnosisTodd, James Campbell
Science
A Manual of Clinical Diagnosis
Todd, James Campbell
Diagnosis, Laboratory
(6) Apply a saturated aqueous or alcoholic solution of Bismarck brown
one-half to one minute, or a weak solution of fuchsin until the film
become pink. The latter {40} probably gives a better contrast stain,
but there is danger of overstaining.
(7) Wash in water, dry, and mount.
By this method Gram-staining bacteria are purple; Gram-decolorizing
bacteria and nuclei of cells are brown or red.
* * * * *
[Illustration: FIG. 11.--Bacillus of influenza; cover-glass
preparation of sputum from a case of influenza, showing the bacilli in
leukocytes; highly magnified (Pfeiffer).]
2. Cells.--These include pus-corpuscles, epithelial cells, and red
blood-corpuscles.
(1) Pus-corpuscles are present in every sputum, and at times the
sputum may consist of little else. They are the polymorphonuclear
leukocytes of the blood, and appear as rounded cells with several
nuclei or one very irregular nucleus (Fig. 8 and Plate II, Fig. 2).
They are frequently filled with granules of coal-dust and are often
much degenerated. Such coal-dust-laden leukocytes are especially
abundant in anthracosis, where angular black particles, both intra-
and extra-cellular, are often so numerous as to color the sputum
(Plate II, Fig. 2, _B_). Occasionally mononuclear leukocytes are
present.
{41} _Eosinophilic leukocytes_ are quite constantly found in large
numbers in the sputum of bronchial asthma near the time of the
paroxysm, and constitute one of the most distinctive features of the
sputum of this disease. They resemble ordinary pus-corpuscles, except
that their cytoplasm is filled with coarse granules having a marked
affinity for eosin. Large numbers of free granules, derived from
disintegrated cells, are also found (Fig. 12).
[Illustration: FIG. 12.--Sputum from a case of asthma showing
leukocytes, some containing eosinophilic granules; free eosinophilic
granules; and micrococci; stained with eosin and methylene-blue
(Jakob).]
Ordinary pus-cells are easily recognized in sputum stained by any of
the methods already given. For eosinophilic cells, some method which
includes eosin must be used. A simple method is to stain the dried and
fixed film two or three minutes with saturated solution of eosin, and
then one-half to one minute with Löffler's methylene-blue; nuclei and
bacteria will be blue, eosinophilic granules bright red.
(2) Epithelial cells may come from any part of the {42} respiratory
tract. A few are always present. They have little diagnostic value,
although a considerable excess would indicate a pathologic condition
at the site of their origin. Any of the stains mentioned above will
show them, and they can usually be identified in unstained sputum. In
general three forms are found:
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