The changes in the adrenal cortex are comparable to those observed in typhoid fever. The analyses of these tissues showed that the cells were almost devoid of cholesterin bodies and few doubly refractile globules could be demonstrated. This change in the adrenal is by no means specific for any acute disease, it being found in many of the severe infections. We regret that systematic analysis of the blood serum in these cases was not made to determine the cholesterin content. If the comparison bears out with typhoid fever, we would expect to find that the quantitative cholesterin of the blood is diminished. Some importance attaches itself to the study of the cholesterin metabolism, particularly in regard to the development of the peculiar fatty streaks which develop in the aorta and other arteries during these acute infections. It has been claimed that in the human these streaks bear an analogy to those produced in the experimental animals and that the arterial lesions are associated with an altered activity on the part of the adrenal cortex in handling the cholesterin compounds. In influenza there is evidence that the adrenal does not function in a normal fashion and that the storage of cholesterin-esters does not take place. From this, however, we cannot conclude that the blood content is increased, and, in fact, it is more than probable in comparing the other reactions of the disease that it follows the changes as seen in typhoid fever where the blood content of cholesterin is lowered. In this way comparison with the experimentally produced arterial lesions in animals is not clear, in as much as in the experimental work a true hypercholesterinemia was induced. Nevertheless it is possible that with the abnormal function on the part of the adrenal the cholesterin materials are made more available for absorption by other tissues and that a true hypercholesterinemia is not necessarily a constant factor, even with the abnormal accumulation of these substances in the intima. It may well be that the normal activity of the adrenal is related to the presence of toxins in the circulation and an attempt by mobilizing cholesterin to diminish the activity of these harmful substances. OBSERVATIONS UPON THE PATHOLOGY OF EIGHTEEN CASES OF INFLUENZA By J. W. MCMEANS