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 recent epidemic of influenza has afforded a series of interesting
autopsies in view of the very extensive and peculiar involvement that
occurred in the lungs of the cases examined. Ordinary lobar pneumonia,
as we know it, was not observed, although it must be said that the lungs
many times exhibited a consolidation of a lobar distribution. The usual
dry granular lung of the more common pneumonia was absent, and in its
stead a most unusual series of pictures was observed in the several
cases. A common feature of all cases was the œdema of the lung tissue,
which in the majority of instances contained such an amount of fluid
that it ran freely from the cut surface in almost unlimited quantity.
This fluid varied in its color and consistence depending upon the age of
the process. In the very early cases the lungs were boggy, very
congested, and a thin serosanguinous fluid poured forth from the cut
surface. It actually appeared as though the fluid within the tissue was
under considerable pressure. At times blotchy deep red hemorrhages
occurred in the lung substance, and hemorrhages of a bright red color
were not infrequent in the pleura. That the circulation of the lungs was
much embarrassed was often prettily demonstrated by the dilatation of
the fine capillaries and lymphatics beneath the pleura. These small
vessels stood out prominently as a meshwork more or less outlining the
areas supplied by them. Not only was the peculiar consolidation in lobar
arrangement, but also in many cases was there evidence of a lobular
distribution. Even in some cases where the entire lobe was consolidated
the cut surface presented a peculiar lobulation with patches of lung
tissue projecting above the general surface. The wet trabeculated
structure of the lung in this stage did not give the impression of true
red hepatization, but rather a structure resembling spleen and at times
a meaty, compact, glassy picture not unlike thyroid.
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