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
Desquamation of the epithelial lining is to be found in every size of
bronchial tube where the infection has caused an acute inflammatory
reaction. Throughout the pulmonary tissues where the lung is found in
some stage of influenzal pneumonia the bronchial tubes, both large and
small, are either entirely denuded of the mucosa or show only remnants
attached to irregular areas. In the smaller passages dense clusters of
desquamated cells are sometimes found within the lumen and indicate the
accumulation of a desquamated epithelium obtained from portions of the
tubular system in deeper portions of the lung. In the early stages, this
desquamation is accompanied by a serous exudate and a certain amount of
hemorrhage. Later we find masses of leucocytes which fill up the tube,
and though appearing to arise from these structures have in fact largely
come from the lung alveoli. Like the larger bronchial tubes the distant
ramifications show relatively little cellular reaction in their walls in
the early period. It is only when the neighboring lung tissues are
extensively implicated in a purulent inflammation that we find a similar
exudate occupying the tissues of the bronchioles. Polymorphonuclear
leucocytes are equally distributed through the region of the basement
membrane, submucosa, muscular coat and outer connective tissue layer.
Some grades of degeneration may occupy the inner surface wherein the
basement membrane first shows a homogeneous swelling and later a
granular degeneration. In a few instances where the small bronchioles
have communicated with regions with abscess formation an ulcerating
surface occupied the inner boundary.
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