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 removal of the infection and the inflammatory exudate from the lung
tissue is accomplished slowly. Clinically the pulmonary process clears
up by lysis, and it is quite unusual to have a crisis with the rapid
disappearance of the serious manifestations. It is difficult to obtain a
clear conception of what takes place in any individual case recovering
from an influenza-pneumonia, but if we have an understanding of what may
occur in the inflamed lung tissue in any one of the stages or varieties
of kind, we may visualize the changing character of the lung condition
tending toward the final restoration.
We have previously pointed out that the early stage of
influenza-pneumonia is one of congestion, œdema, hemorrhage and more or
less leucocytic infiltration, and that this reaction differs materially
from that observed in pneumococcus lobar pneumonia. There being no stage
of true red hepatization, it has also become apparent that this peculiar
primary reaction need not pass into the stage of gray consolidation.
Scattered areas in the lung pass from the condition of acute serous and
hemorrhagic pneumonia to a type of purulent pneumonia while much of the
remaining tissue continues in the state as seen in the early reaction. A
certain amount of cellular exudate makes its appearance but not
sufficient to lead to a true consolidation. This variety of reaction is
present from the fifth day of the pneumonia onwards and may continue
with all of its varieties through until the tenth or twelfth day or even
longer when recovery from the infection is beginning. Thus the stage of
resolution makes its appearance before the inflammatory reaction in the
involved lobes has assumed a common character and where we are able to
recognize different grades of severity and different stages of
inflammation within the same lobe. Resolution taking place in such a
lobe has responses occurring in the different parts determined by the
nature of the antecedent reaction. We have found that those portions
which have not advanced beyond the stage of œdema and hemorrhage may
clear up with the disappearance of this early exudate and its infection.
In a neighboring portion the purulent inflammation passes through phases
differing somewhat from the preceding but also tending toward the
restoration of the parenchyma and the disappearance of the inflammation.
It would be incorrect to consider the resolution of the early type of
inflammatory reaction as an abortive process inasmuch as it is not yet
clear whether this serous and hemorrhagic process is not the
characteristic inflammation of a peculiar micro-organism or organisms
and that when acting alone these bacteria do not in themselves stimulate
a further inflammatory response. Hence if it is true that there is a
peculiar inflammatory reaction of a non-suppurative and non-fibrinous
kind the manner of resolution will differ somewhat from that where these
other constituents of the exudate are present. It becomes clear,
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account