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
thrombosed capillaries, arterioles and venules in these surface layers.
These thromboses took place while the vessel was in its distended state
and thus produced a mold of the dilated vessel. This observation is of
importance in indicating the severity of the effect of the virus and
toxin upon the tissues of the trachea, and it is also of importance to
appreciate that this damaging influence is very different from that
which we encounter in pneumococcus infections, and we shall point out in
our discussion on lung a reaction very similar to that which takes place
very superficially in the trachea may also occur in the alveolar walls
of the lung.
Having referred to the intensity of the responses of the blood vascular
system, we must also indicate the part played by the lymphatics.
Simultaneously with the reactions taking place about the blood vessels
of the trachea we observed similar responses in the lymphatic channels.
At first these dilated structures contained only fluid. Later the
migration of the lymphocytes took place along these routes, and rarely
micro-organisms could be demonstrated either free or within an
occasional leucocyte. The sharp response of the lymphatics during the
serous inflammation is noteworthy, inasmuch as we have found that the
lymph glands lying about the respiratory tubes and lungs were early in
their response to the irritating virus.
Bacteria were demonstrated in the secretions lying upon the surface of
the trachea. In those specimens in which the mucous membrane was still
intact we attempted to demonstrate the clustering of the micro-organisms
about the ciliated cells as was described by Mallory in whooping cough.
Although the organisms, and particularly small Gram negative bacilli,
could be demonstrated lying about these cells no characteristic
arrangement was found. Furthermore where the mucosa was still attached
to its basement membrane we were never able to demonstrate organisms
below the surface of the epithelial layer. In several cases where the
mucosa was lifted in bleb-like structures a number of organisms were
detected below the epithelial layer and in contact with the basement
membrane of the submucosa. We have rarely demonstrated bacteria in the
interstitial spaces of the submucosa, even where large numbers of
organisms were lying upon the inner denuded surface.
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