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 lesions occurring in the abdominal viscera were of less importance
than those within the thorax. In none of the cases of the epidemic was
the intestinal type of the disease, described in previous years,
encountered. The changes found in the various viscera were concomitant
with evidences of intoxication as observed clinically or at autopsy in
other regions of the body. We found no evidence that the bacteria of the
disease localized in the tissues of the abdominal viscera, and we were
led to believe that the alterations in morphology and function were the
result of diffusible toxins. The action of these toxins was either upon
the parenchymatous cells of the organs, as in the liver and kidney,
resulting in granular degeneration, or upon the capillaries with the
development of petechial or diffuse hemorrhage as was encountered in the
stomach, intestines and bladder. The absence of definite localized
inflammatory processes in these distant tissues, including the abdominal
lymphatics, speaks against the probability of a bacteriæmia playing an
important role in the disease. That transient bacteriæmias by the
influenza bacillus do occur has been repeatedly demonstrated, and that
the organisms associated with this bacillus may also enter the blood
stream has likewise been found. But these states are accessory to the
disease, and must be viewed as complications rather than the rule. Hence
the occasional observations by some, of bacterial inflammatory reactions
in liver and kidney must not be considered a part of epidemic influenza,
for in many cases it is wanting. The majority of lesions of the
abdominal viscera probably arise through the action of the unknown toxin
in the blood.
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