On 25 October I subjected the sputum to another examination. It presents as a phlegmy, saliva-like liquid in which is suspended a large number of small yellowish flakes slightly different in shape, and numerous black dots of irregular shape that disintegrate under the pincers. Under the microscope the black dots show: a) in part large, cellular forms of the size and shape of pulmonary epithelia, in part smaller cells of the size of the phlegmy corpuscles, the majority of which contain larger, angular, black particles; b) in some places extensive groups of mostly large, angular, black particles, some of which are shaped like echinococcal hooks, but which also possess a variety of other forms and all of which are sharply outlined; c) a moderate amount of red blood cells that have turned pale. Most of the cells resembling the phlegmy corpuscles contain several small nuclei, up to as many as four.
The following observations were made between October 26 and November 4:
Lying on his back continuously with elevated upper body and difficulty moving. Because of the constantly increasing hydropsy, the patient is tormented by frequent, very violent, and long-lasting paroxysms of coughing, as a result of which the already significant difficulty breathing is considerably exacerbated. During the fits of coughing the otherwise non-significant cyanosis also became so severe that the face and neck turned a very dark blue. At the same time the patient complained about strong pain in the right side and about a feeling as though his body was about to explode. The sputum, always produced only after great effort and amounting to about 34 ounces in 24 hours, consists, as before, of a strongly translucent, cloudy, gray, saliva-like liquid, in which the mucopurulent flakes are becoming increasingly yellow, less translucent, larger, and more numerous, while the amount of the black spots remains fairly constant. The latter are found both in the liquid and within the yellow flakes and consistently show, under microscopic examination, a large number of the described black particles, the vast majority of which are not enclosed within cells. Particularly striking among the myriad forms presented by these in part very long, angular corpuscles are those that show one or two regular, circular openings – nearly always equal in size – in their interior, or variously-sized segments of such openings at the edge. Upon repeated examination, brownish particles tending towards red, otherwise the same, were also noted among the black particles.
[ . . . ]
Source: “Ueber das Eindringen feiner Kohlentheilchen in das Innere des Respirationsapparates. Von Professor Traube.” Deutsche Klinik, vol. 12, no. 49 (1860), pp. 475-78.
Translation: Thomas Dunlap
print version
return to list
previous document