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 early pulmonary lesion which we have described, we have called acute
serous pneumonia and acute hemorrhagic pneumonia (or we might speak of
it as an acute sero-hemorrhagic pneumonia) and is one which is
distinctive for epidemic influenza. The cut surface of a lobe involved
in this reaction is wet, glassy, meaty and oozes much blood-stained
fluid. It contains no visible fibrin and presents no characters of a
“cellular consolidation.” As a serous inflammation of the lung it is
unique. The further remarkable character to the pulmonary lesion is that
in advancing through the other stages, it never passes through a stage
of “red hepatization.” Here again we have a distinctive difference from
the pneumococcus-pneumonia. From what we have previously said about the
nature of this early acute inflammation of the lung in this disease it
is apparent that red hepatization has no place in its process. The stage
of red hepatization is attained only when the inflammatory reaction is
accompanied by certain constituents in the exudate, which upon
coagulation (separation out of the fibrin) renders the lobe dry and
solid, while there is a sufficient abundance of red blood cells and
congestion to maintain a dark red color. The hepatized lung on section
is dry, more or less granular, containing fibrin, red cells and
leucocytes within the alveoli. Extensive œdema is unusual except in the
cases of hypostatic pneumonia, which in well marked cases bears some
resemblance to the gross appearance of the early influenza pneumonia. We
have not encountered a single case of the red meaty lung of influenza
which showed evidence of true red hepatization in the gross.
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