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
The pathological changes found in the nose, pharynx and larynx were of
relatively slight importance and most variable in their severity and
incidence. The majority of individuals had few clinical manifestations
of disease in these parts. Some, however, complained of dryness of the
pharynx with slight feeling of fullness. An examination of these parts
revealed some congestion, varying from a red injected mucosa to a bluish
cyanosis. In the nose the reaction was rarely as acute as is seen in
infectious coryza, but even where relatively little change was to be
seen in the tissues hemorrhage from the erectile tissue was not uncommon
during the acute stages. No particular lesion was to be found associated
with nose bleed. There was an unusual absence of excessive secretion
from nose and pharynx in the majority of cases. One was also struck with
the infrequency with which the larynx was involved. A certain number of
individuals complained of hoarseness, and in them injection of the vocal
cords with some swelling was found. In many others, however, even where
an intense infectious process was present in the lower respiratory tract
the larynx was almost without change. It was from the level below the
larynx that the acute reaction in the respiratory system was found.
In all of our cases the trachea showed definite inflammatory reaction.
Of the 32 cases there were 26 having an acute tracheitis, 5 with an
acute mucopurulent inflammation and 1 with a reaction in the subacute
stage. In the majority of the cases with acute tracheitis there was a
thin layer of exudate lying upon the mucosal surface. At times the
trachea was filled with a frothy serous fluid, the greater part of which
had its origin in the lung. Nevertheless, as we shall point out later,
we did obtain microscopical evidence indicating that during the early
acute stage of the tracheitis a considerable serous exudate escapes from
its mucosa. This serous inflammatory reaction is an important one for
all of the mucosal structures upon which the virus of influenza obtains
a footing. This we have found true for the trachea, bronchi and alveoli
of the lungs. In some cases the exudate was grey and lay in close
contact with the injected tissues. At first sight this grey exudate
suggested necrosis, but it was readily wiped from the underlying
structure. Some leucocytes and cell debris with many bacteria made up
the content of this grey exudate.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account