There are three other characters which differentiate this gray stage from those of ordinary pneumonias—(1) the irregular distribution, (2) the friability of the involved tissue and (3) the interstitial reaction. We have never observed such an irregularity in the distribution of a gray stage of pneumonia as we have seen it develop in acute influenza-pneumonia. All types of involvement of the lobes are found in different cases and even sometimes in the same case. The least frequent type has been the broncho-pneumonia in its true form. Broncho-pneumonia as we see it in children and the cases following measles is usually fairly uniformly seeded through several lobes and the size of the individual patches is about that of a split pea. The small bronchus can be recognized about the center of the involvement. In those instances one has studded through the lung tissue numerous small swollen areas which are granular, dry and gray. Differing from this the patchy distribution of the gray stage of influenza-pneumonia had no regularity either in the size of the areas nor the distribution. A lobe may show one or more patches. The patches may be distributed toward one portion of the lobe more than another. Furthermore the areas do not always encircle the small bronchi but involve the terminal portion so that an entire lobule is more commonly affected. The lobular type rather than the peribronchial type is most commonly seen and it is often remarkable how sharply the gray lobule is demarcated from the surrounding congested lung tissue. On several occasions we observed a single lobule in the gray stage while the remaining portion of the lobe was in the serous and hemorrhagic condition. However, multiple lobules are commonly seen closely associated in the advancing inflammatory process. Such lobules show peculiar geographical patches or leaflet-like configuration. Varying with the number of lobules involved the extent of the gray change in the lobes assumed more or less a lobar distribution. There was no uniform position to this pneumonic state sometimes appearing in the peripheral tissues of the lung, at other times lying centrally with less involved or less advanced inflammatory reactions surrounding it. Nevertheless, the gray stage made its appearance more rapidly in the lower lobe than the upper and it was not uncommon to find this condition appearing quite early in the upper posterior portion of the lower lobes. This latter position is the one which is recognized during life by the clinician as one of the earliest localizations of the demonstrable pneumonia. It is reported by many that the first physical signs of consolidation are to be obtained close to the lower angles of the scapulae.