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
involvement, we can estimate approximately, at least, the duration of
the lung condition. This makes it possible to give a relative estimate
of the character of the lesions present at different periods of time.
The outstanding finding, as we will discuss again, was that a distinct
and peculiar pulmonary reaction was primarily imposed upon the lung,
which made its appearance at periods different from those of frank lobar
pneumonia.
We were repeatedly surprised at finding death to have occurred during
the stage of acute congestion with some hemorrhage and inflammatory
œdema of lung and in the absence of any sign of grey hepatization or
purulent infiltration. In many of these cases the involved areas of lung
though heavy and œdematous, were still partly air-containing and the
amount of lung involvement was insufficient, on the basis of mechanical
interference, in accounting for the severity of the clinical symptoms
and the fatal outcome. This must have impressed everyone dealing with
the autopsies during the acute epidemic. It immediately suggests that in
some cases at least the pulmonary lesion, in as far as incapacitating
the external respiratory system, was not the sole or even the important
cause of death, but that a condition of intoxication, borne out by the
evidence of damage in muscles, blood and kidney is a large factor of
danger in this disease.
We shall briefly describe the important pulmonary findings as we have
met with them in the successive stages of influenza-pneumonia. This, we
hope, will make clear the interpretation of the pathology of the lung
lesion of the epidemic as it came under our observation.
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