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
separated from each other by constricted areas in which the original
myoplasm has undergone decomposition and sometimes complete absorption.
This irregular destruction of the muscle contents often has a granular
stage in which the original muscle substance has become disintegrated.
The sarcolemma follows the condition within it, stretching when the
fiber is swollen and shrinking, or even becoming collapsed when the
inner substance is becoming liquified and absorbed. The sarcolemma does
not suffer the degenerative changes of the inner fiber, nor can one
observe nuclear changes in this sheath which are significant.
When first studying this process of degeneration it appeared to us that
the earliest change was a loss of the transverse striations and the
subsequent disappearance of the longitudinal fibrillæ. We have
subsequently found that this is incorrect and that the changes observed
in the markings of the fibers were not constant. At times the muscle
substance would progress through stages of degeneration up to the point
of disintegration and dissolution while the transverse striæ were still
discernible in the altered fiber. The one constant change that we have
observed in the degenerating fibers was the early loss of staining
qualities as obtained by the phosphotungstic acid hematoxylin. In such
preparations the earliest effect of the intoxication upon the muscle
fiber was a change in reaction to this stain. Sometimes within a given
fiber small irregular and poorly staining blotches could be observed,
while the remaining portion of the fiber was normal in its appearance.
Later these poorly staining areas became larger, occupying the entire
width of the fiber and being distributed at irregular intervals in its
length. Finally the characteristic staining quality was entirely lost,
although in the poorly colored cell transverse striations were still
discernible and a true waxy stage had not yet taken place.
At times the waxy degeneration advanced into the stage of disintegration
by an irregular destruction within the fiber. When this occurred the
fragments of waxy substance took on curious coiled and grotesque shapes,
while a granular destruction was taking place in their periphery.
Neither inflammation, œdema nor a vascular reaction could be determined
in these tissues of mild or severe change. The reaction as is indicated
in the table occurred quite acutely and was not accompanied by fatty
products commonly seen in the slower forms of degeneration.
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