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
We cannot, however, correlate our findings with the classification of
pneumonias as given by MacCallum. His claim for specific types of
pneumonia as a sequel to influenza is based upon his statement that “no
satisfactory evidence has been brought forward to show that the epidemic
influenza is a bacterial infection. It is evidently a general or
systematic infection not especially affecting the respiratory tract and
analogous in many respects, as Bloomfield has pointed out, to the acute
exanthematic diseases.” Thus we are confronted by two schools concerning
the nature of influenza. The one claiming that epidemic influenza is
essentially a disease of the respiratory system and the other completely
denying this.
I am unable to understand the claims which are put forward to
substantiate the second view.
The classification of the pneumonias as suggested by MacCallum would be
valuable if it could be applied in a practical manner. We find, however,
that his description for the pneumococcus-pneumonia hardly coincides
with common observations on endemic pneumonia and if the description is
to apply only to the pneumonias associated with influenza wherein
pneumococcus alone is isolated we find that our own observations do not
coincide with this. The picture offered by MacCallum under this heading
was reproduced when the bacteriological findings illustrated the
presence of organisms other than the pneumococcus or combinations of
these. The most characteristic of his description is the one for the
streptococcus-pneumonia which when present alone gives quite a unique
picture. The picture, however, is to a certain degree modified by the
reactions which precede the streptococcus in the lung. Furthermore to
offer as a characteristic picture for the influenza infection of the
bronchi the presence of a thick yellow pus is hardly complete inasmuch
as this exudate appeared only as a stage in the inflammatory process.
The intense serous and hemorrhagic response observed early in this type
of infection is more unique than the presence of pus which appears
somewhat later and which may occur with infections other than the B.
influenzæ. It has long been the hope in pathology to be able to
establish by the character of the tissue reaction, the nature of the
infecting agent. Up to the present this has been possible only with a
very few types of bacteria.
_Lung—Stage of Resolution_
Public-domain text, read in full here on John Shaqi.
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