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
In types of epidemic disease such as we have just had, where the
epidemic wave has passed over in a period of four or five weeks, there
is always much to be regretted which has been left undone. We tried as
far as possible to gain all the information available at the time of
collecting our materials and of laying aside such of the work which
could be accomplished at a subsequent date. The materials were collected
from divergent sources in the cadaver, and the more perishable
substances were analyzed immediately. During the period of the epidemic
32 autopsies were performed and as much use as possible was made of each
for a thorough comprehension of the lesions.
_Materials_
During the period of our work 639 patients were admitted to the hospital
suffering from clinical influenza. The cases varied in type from the
very mild to the extremely ill. The majority of the cases were of the
type of “three-day fever.” Clinically 81 cases developed pneumonia, and
of these, 35 died. It would, of course, be impossible to say how many
other individuals had a pulmonary involvement which could not be
recognized clinically. In fact, some of the cases which did come to
autopsy were only recognized as having a pulmonary involvement when the
lungs were examined outside of the body. The physicians freely admitted
that the physical signs were quite unusual and unlike those of the
ordinary forms of pneumonia. In fact, except for the fact that we were
living in the midst of an epidemic of respiratory infections, there was
nothing to make the clinician suspect that many of these cases had a
pulmonary involvement. Obviously, when the recognized signs of different
types of pneumonia made their appearance, the clinician did not fail to
make proper interpretation of the lung involvement. This, as we shall
discuss later, is an event superadded to a lung condition which
pathologically must be recognized as pneumonia (inflammation) and which
differs so decidedly from what we know of as croupous or lobar
pneumonia, as well as ordinary broncho-pneumonia that it would be
incorrect to include them under this heading, although the distribution
of the lesion may have lobar, bronchial or lobular characters.
TABLE I
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