this way somewhat reduce the grade of anthracosis. A considerable discussion has arisen concerning the proper nomenclature for the pneumonia or pneumonias found in epidemic influenza. From some quarters have come the reports of a true lobar pneumonia, from others a lobular or broncho-pneumonia and others again claim that the reaction is an interstitial pneumonia of varying distribution. It appeared to us that the gross distribution of the lesions is not alone the criterion for a proper appreciation of the inflammatory states which may arise within the lung. I believe it has been amply demonstrated that the pneumonic reactions appearing in different regions of the United States as well as in different countries are not of a constant kind when viewed alone in the light of the gross picture nor are they constant from the standpoint of their bacteriology. We are of the opinion that the earlier phases of the pulmonary reaction are fairly constant in different places and that this constancy is dependent upon the common virus which initiates the respiratory lesion and which then permits a variety of micro-organisms invading as secondary agents. The secondary agents vary with the community and depending upon their nature the character of the reaction differs from that in other places. It has been well demonstrated that in some regions the hemolytic streptococcus is the important organism following the primary injury by the initial virus. In other places the pneumococcus or the staphylococcus or the M. catarrhalis is found to be of primary importance. Up to the present it has not been shown that the influenza bacillus is not the important organism causing the initial reaction and being responsible for the opportunity of secondary invaders leading to such diverse reactions in the lung. In our series we have met with lobar, lobular, interstitial and broncho-pneumonic types. We have not observed a case of the miliary bronchial reaction as described and illustrated by Goodpasture and Burnett and fully investigated by MacCallum. Moreover we have not met with the type of purulent bronchitis as a characteristic lesion preceding pulmonary involvement. The occurrence of pus within the bronchi occurred not early in the pulmonary lesion but later after the bronchi and bronchioles had passed through their stages of acute, serous and hemorrhagic pneumonia and were entering upon their secondary stage with pus production. The pulmonary lesion had long preceded the appearance of pus in the bronchi. We do not hold, however, that such relations between the pulmonary lesion and the purulent bronchitis do not exist for there is evidence that in particular regions this sequence of events was closely observed.