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
In all cases except one there was an exudate in one or both pleural
cavities. A serofibrinous pleurisy was noted in 11 cases with, in 2 of
this number, a fibrino-purulent reaction present in the opposite pleural
cavity, while fibrino-purulent pleurisy occurred alone in 6. In 6 cases
pleurisy occurred on one side only with the incidence equally divided in
each cavity. Both pleurae were involved in 9 cases. Seventeen of the 18
cases showed both lungs involved. One case was an individual who had had
clinical influenza and during convalescence developed gangrenous colitis
and acute ascending myelitis which terminated fatally. B. influenzæ was
isolated from the bronchioles in the lung of this individual.
The reaction of the body generally was evidenced by a widespread
distribution of petechial hemorrhages over serosal and mucosal surfaces.
However, certain other important lesions were noted such as one acute
vegetative mitral endocarditis, two acute serofibrinous pericarditis,
three cases in which focal necroses were prominent in the liver and two
examples of infarct of spleen. Further, there were four cases of slight
dilatation of the right heart. The liver was usually swollen and
œdematous and the spleen presented evidence of an acute reaction,
softening and reddening of its pulp with at times slight enlargement.
As evidence of the virulent character of the infection from which these
patients suffered, there was not only present in the lung a peculiar
hemorrhage and purulent process, but also a more or less widespread
distribution of hemorrhages in other parts of the body. The
gastro-intestinal tract was most affected with the stomach showing
petechial hemorrhages in 17 of 18 cases and the small intestine in 15 of
the same number. In the gastric mucosa of three cases there were
definite erosions, while in two instances the duodenum presented an
intense œdematous and hemorrhagic appearance of its mucosa. Further
hemorrhages were observed on one occasion each in the mesentery and in
the mesenteric and retroperitoneal lymph nodes. In the latter the
mesenteric glands were so distended with hemorrhages that a soft pulp
spurted out when the glands were sectioned. Next in order of frequency,
hemorrhages were noted 9 times in the pleura, 8 in the pelvis of the
kidney, 6 in heart muscle and 3 each in pericardium and bladder. In one
case of widespread distribution of petechial hemorrhages there was a
massive loose hemorrhage into the lower recti abdominis. Further another
case showed a large amount of a blood-stained fluid in the peritoneal
cavity.
_Summary_
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