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
As the process advanced the appearance of the lung changed from deep red
to yellowish red and finally to a quite yellowish gray color, still
retaining, however, the very moist characters. The fluid found in the
lung changed its consistency from the thin red type to a sticky, glairy
variety which could be pulled out in long strings. It was noted that the
change in the character of the fluid was accompanied by similar changes
in the lung structure, advancing in two cases to abscess formation of a
grape-bunch type. Here there was a rather extensive necrosis and
cavitation of lung substance in communication with the bronchioles.
However, there was also marked softening and necrosis of lung in a
number of cases where abscesses did not develop, but the lesion was so
advanced that the lung substance was almost diffluent. An accompaniment
of these advanced cases were irregular yellow islands which appeared
beneath the pleura. At times they reached the size of a circle 2 cm. in
diameter and were slightly raised above the surrounding pleural surface.
When these were opened they were found to be areas of softened lung
substance. This reaction was so extensive in some lungs that it
resembled to a degree the appearance of a caseous pneumonia. However,
the former process appeared to be brought about by the interference with
the lymphatic drainage, as it was not uncommon to see engorged yellow
channels beneath the pleura as well as enlarged lymph nodes at some
distance from the hilus. Another feature of the advanced cases were the
plugs of ropy yellow material which were contained within the
bronchioles, while in the early cases the bronchi and bronchioles showed
intense congestion of the mucosa with blood-stained fluid in their
lumina.
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