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July 27. 1907.] ALLEN: PHAGOCYTOSIS IN SPUTUM. 163 any observation based on phagocytosis probably has to do with fairly recent events. Of course sections of the lung show what has occurred, but only one observation can be made, and the resistance of the individual is too delicate a mechanism to be com- prehended so Alesse Vs Yaz briefly. The sputum attords repeated observations. II. Plijgocytosis ill the Sputum. In doing routine sputum examinations Alesse Acne one occa- sionally obsen-es specimens that present Aviane Vs Alesse so many tubercle bacilli inside the leucocytes that they might easily be mistaken for preparations in opsonin work. In some specimens some of the leucocytes contain as many as eight tubercle bacilli. The inclusion of so many bacilli is hardly insignificant. To inter- pret their meaning is a difficult problem : e. g., the diplococcus intracellularis is inside the cells in the spinal fluid of meningitis, and the gonococcus is in- side the cells in the urethral discharge. Tliese Alesse Ocp in- closures of bacteria would seem to give no indica- tion Purchase Alesse as to immunity. The normal habitat for these organisms may be inside the cells ; this is not so with tubercle bacilli. Phagocytosis plays an important role in tubercu- losis. (Wright, Baldwin, Hektoen, Alesse 21 and others.) Theobald Smith opposes this view. Carles says ex- amination of the efficiency of the leucocytes should rank with examination of urine, etc. Cohnheim injected carmine granules into the dor- sal lymph sac of a frog and then provoked a cor- neal suppuration. He found the leucocytes in the cornea laden with carmine granules. Thus the leu- cocytes rush to different parts of the body where there is inflammation. W. L. Brown injected carmine granules into the Alesse For Acne foot of the unio, and in twenty-four hours found leucocytes that had englobed the carmine wandering through the membrane of the gills. Order Alesse Online De Bruyne also observed in molluscs the leucocytes passing out through the gills laden with histological residues, etc. Alesse Vs Aviane Stohr found that tonsils and Peyer's patches were sites of constant outwandering. Metchnikoff^ believes that the tonsils give off many leucocytes, and that these account Yaz Vs Alesse for the compara- tive immunity of the buccal cavity. Outwandering leucocytes might account for the comparative im- munity of the larynx and the other upper air pas- sages. I have not yet made special observations on the sputum of patients with tuberculous larynx. If phagocytosis outside the tissues, that is in cav- ities or in bronchi, did occur we sliould find the leucocytes active, and the tubercle bacilli opsoni- fied or opsonin Alesse Price present. Lowenstein tested the ability of the pus cells from the sputum to phagocyte in vitro by homogenizing with shot a fresh sputum, adding Alesse Discontinued tubercle bacilli and serum, and incubating. Sputa were taken from pa- tients with oj)en and closed tuberculosis, and pa- tients undergoing Alesse Cost various kinds Alesse Generic Brand of treatment. In none was there phagocytosis. He states that the mucus and .saliva probably interfered with the movement of the leucocytes, and with llic complete homogeneous mixing of the bacilli. There might be very little Buy Alesse Online mucus in cavities. Arc the tubercle bacilli in the sputum opsonified? The author added washed leucocytes Alesse Mg from the blood to the mechanically homogenized sputum and found no phagocytosis. After the addition of serum, however, phagocytosis did Alesse And Acne occur, thus showing that the sputum Buy Alesse lacked in opsonin. Two such tests were made ; in each the sputum used was a mixture of the sputa from six patients. This point will be studied further. Ross says that A. E. Wright tested for opsonin in the fluid expressed from sputum and found it absent. Lowenstein observed that the intracellular tuber- cle bacilli in sputum showed signs of disintegra- tion. I failed to find this. IMarkl and others have observed the disintegration Alesse Generics of tubercle bacilli en- globed when injected intraperitoneally.

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