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
A fair literature has already appeared upon epidemic influenza from the
many countries and regions over which the present pandemic (1918) has
swept. These reports by various authors are offered from different
viewpoints, some investigators being impressed with certain features
which they bring into marked prominence in their reports. It thus
happens that up to the present there is a decided lack of uniformity in
the opinions expressed upon different phases of the subject. The nature
of the pathology of the past epidemic has given rise to many expressions
of opinion as well as dogmatic statements, which are found to differ
from those of others. It seems to us that this apparent confusion arises
partly through the somewhat different characteristics of the disease as
it has made its appearance in different centers. We hear it repeatedly
stated that the types found in different military camps and urban
communities were quite unlike those of other regions. It is evident that
such differences in the clinical course actually did exist and that the
epidemic though having a common foundation upon which the disease
process was built differed in what might be looked upon as symbiotic
complications during the early and acute stages. Differences in the
nature of the findings in various communities also probably lay in the
fact that the bacterial flora associated with the causative agent of
influenza was quite different in different regions. We mention this here
so that a full appreciation will be obtained for the differences in the
pathological characters of the disease as they are found in one region
or another. We appreciate, of course, that if the concomitant bacterial
flora associated with the underlying cause of influenza, differs in
different regions, so, too, will the bodily reactions differ within
certain degrees. We are becoming more familiar with different types of
bacteria, and the resulting inflammatory reaction which is often unique
or at least particular, and that not uncommonly the nature of the
inflammatory process suggests the type of bacterium involved. This
argument, of course, must not be driven too far, for we well know that
the same micro-organisms under different conditions can cause types of
inflammatory reactions wholly divergent.
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