The hemorrhagic and edematous consolidation of the early pulmonary lesions of influenzal pneumonia is their most distinctive feature. Red confluent lobular pneumonia is frequently found in those who have died within the first week following the onset of influenza. The lungs are voluminous and heavy and may weigh as much as 1,500 grams; the pleura which overlies the consolidated area is blue or plum colored and usually shows scant if any evidence of pleurisy. Scattered patches of consolidation are accurately limited to lobules, but in addition there are large areas often involving the greater part of the lobes and not infrequently situated in the lowermost part of the lower lobes. This confluent consolidation may be obviously limited by lobule boundaries. The consolidated tissue is deep red and laxly consolidated; red serous fluid escapes from the cut surface. The lesion not infrequently occurs in association with hemorrhagic peribronchiolar pneumonia. The histology of this confluent lesion has been studied in Autopsies 242, 244, 303, 336, 464, 474 and 506. The histology varies, because, in some instances, leucocytes, in other instances, fibrin, is abundant, but the presence of red blood corpuscles in large number within the alveoli gives a red color to the consolidated tissue. In these cases pneumococci, associated in the lungs or in the bronchi with B. influenzæ, have been the cause of pneumonia. In two autopsies studied histologically (Autopsies 274 and 478) there was red lobular and confluent pneumonia and the blood and lungs contain hemolytic streptococci demonstrated by cultures; microscopic examination showed the presence of a widespread necrosis of the lung tissue. In the group of autopsies in Table XL there was red confluent lobular pneumonia. These autopsies are separated from those just cited because there was no histologic examination of the tissue. TABLE XL ═════════════════╤═════════════════╤═════════════════╤═════════════════ NO. OF AUTOPSY │ BACTERIOLOGY OF │ BACTERIOLOGY OF │ BACTERIOLOGY OF │ HEART’S BLOOD │ LUNGS │ BRONCHUS ─────────────────┼─────────────────┼─────────────────┼───────────────── 289 │ Pneum. IV │ Pneum. IV │ Pneum. IV, B. │ │ │ inf., staph. 297 │ │ Pneum. IV, B. │ Pneum. IV, B. │ │ inf. │inf., S. hem. (a │ │ │ few) 306 │ │ │ 339 │ Pneum. IV │ │ 364 │ S. hem. │ │ 418 │ Pneum. atyp. II │Pneum. atyp. II, │ │ │B. inf., S. vir. │ 424 │ │ Pneum. IV. │ ─────────────────┴─────────────────┴─────────────────┴─────────────────