Crystals

Besides the crystals of fatty acids and their soaps the following crystals are met with in the faeces: oxalate of lime appears in the well-known envelope form of varying size, especially after a diet consisting principally of vegetables. Calcium carbonate occasionally occurs in the form of amorphous granules or dumbbell-shaped crystals. Neutral phosphate of calcium and ammonio-magnesium phosphate crystals are often present and can be readily recognized, the former occurring in more or less well-defined wedge-shaped crystals collected into rosettes, the latter presenting the well-known coffin shape. They are soluble in acetic acid. All the crystals just mentioned are found in normal as well as in pathological faeces, and have no diagnostic importance. Bismuth crystals: when bismuth is internally administered it is usually found in the faeces in rhomboid crystals of a dark-brown or almost black color (Fig. 20). Haematoidin crystals are occasionally encountered in severe catarrhal conditions of the intestines or shortly after intestinal hemorrhages have taken place. They occur in small amorphous particles of an orange or ruby red color, or in crystals of the rhombic system.

Charcot-Leyden crystals of spermin phosphate, having the shape of grains of oats, are occasionally met with in the faeces and are of diagnostic importance. According to Leichtenstern,1 these crvstals are very frequently found in the feces whenever intestinal parasites (helminthiasis) exist. These crystals, however, occur also in other pathological conditions as in typhoid fever, dysentery, tuberculosis of the lungs. In rare instances the Charcot-Leyden crystals are absent in cases of helminthiasis. When they occur, however, they are an indication that the stools should be carefully watched for the presence of intestinal worms.

1 Rieder: Deutsches Archiv fur klin. Med., 1898, Bd. 59, Heft 3 and 4, p. 444.

Specimen of Stool of Mrs

Fig. 20. - Specimen of Stool of Mrs. W., living on Milk Diet and taking Bismuth and Magnesia. Bismuth and magnesia crystals, some fat globules and detritus. No muscle or plant cells.

1 Leichtenstern: Deutsche raed. Wochenschrift, 1892, No. 25.

Elements Derived From The Intestinal Wall

Epithelial cells and also goblet cells occur occasionally in the faeces, but only in scanty number (Fig. 21). They are very seldom unchanged with a distinctly visible nucleus; usually they appear in a metamorphosed condition without any perceptible nucleus. Larger accumulations of epithelial cells may be found in desquamative catarrhal conditions of the intestines.

Fro. 21.   Specimen of Stool of Mrs. V.. with Chronic Intestinal Catarrh. Groups of epithelial cells; detritus; a few muscle cells, partly digested; plant cells; bacteria; yeast cells.

Fro. 21. - Specimen of Stool of Mrs. V.. with Chronic Intestinal Catarrh. Groups of epithelial cells; detritus; a few muscle cells, partly digested; plant cells; bacteria; yeast cells.

Blood

Blood in the faeces is occasionally easily recognized under the microscope, both red and white blood corpuscles being present. This, however, is the fact only in hemorrhages of the lower portion of the rectum. In hemorrhages originating in the upper portion of the large bowel or in the small intestine, the blood cells are usually already greatly changed and not to be recognized as such microscopically.