Studies on Epidemic Influenza: Comprising Clinical and Laboratory InvestigationsUniversity of Pittsburgh. School of Medicine
History
Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations
University of Pittsburgh. School of Medicine
Influenza; Influenza Epidemic, 1918-1919
I have discussed in another place the suggestion of the stimulating
effect of various bacteria on the growth and toxine production of B.
influenzæ. Huntoon showed the effect of hemolytic streptococci in
cultures to be helpful in toxine production. An important point,
however, is that no one bacterium has been shown to be exclusive in thus
affecting the growth on media of the influenza bacillus, and in the
animal experiments in raising the invasive and pathogenic power of this
organism the same appears to be true. The infection in influenza, in the
vast majority of cases, rapidly becomes a mixed one. The secondary
organisms at times completely dominating the field, at least as far as
numbers go, most frequently invade the blood stream and it would appear
often play the important role in many of the secondary conditions.
_Chronic Infections_
B. influenzæ is a frequent finding in the sputum of patients with
chronic bronchitis, pulmonary tuberculosis and other chronic conditions
in the respiratory tract. Boggs recovered this bacillus from two cases
of bronchiectasis, Richards and Gurd had a similar case and Tedesko
reported several. The literature is filled with references to the
finding of B. influenzæ in cases of chronic bronchitis. Those reported
by Lord, Madison and Tedesko quoted above will serve as examples. The
frequent positive cultures in cases of pulmonary tuberculosis so often
referred to in reviews of the literature and the significance of these
findings, as pointed out by Scheller, are important as bearing on the
much debated subject of the effect of influenza on this disease. These
types of chronic infection by the influenza bacillus should be more
generally recognized as they undoubtedly will become more numerous
following this last epidemic if we can judge from the experience of the
past.
_Infections of the Pleura_
The recovery of B. influenzæ from the pleural cavity is not uncommon as
is shown in the above review. The findings of MacCallum, Cole and others
during the spring of 1918 are particularly interesting. Beall in 1906
reported a case of empyema with large quantities of green pus in which
B. influenzæ was found in pure culture.
_Sinuses of the Head_
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