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 several cases we also detected an osteitis, especially of the bodies
of the vertebræ. One was of the cervical vertebræ and the other of the
dorsal. The first died after intense suffering. An autopsy was not
obtained. The other had a plaster cast applied as in Pott’s disease, and
improved sufficiently to leave the hospital in comfort. One hesitates
under the circumstances to attribute these bone lesions definitely to
the same infecting micro-organism which was responsible for the epidemic
of influenza, as it might easily have happened that a coincident
quiescent tuberculous lesion was present and relighted during the
epidemic. However, in one case from the service of Dr. J. O. Wallace the
possibility of the bone lesions being due to the Pfeiffer bacillus was
demonstrated. This was a child of 16 months with an epiphysitis of the
upper end of the tibia. The inflamed area was incised and pus was found.
A smear at the time showed the B. influenzæ, which was grown in pure
culture.
A most interesting complication noted in a few of our cases was a
transient glycosuria. The first case brought to our attention was a
middle-aged female, who complained of failure of vision. Upon making an
ophthalmoscopic examination a papillitis of a mild type was noticed.
This led to a careful study of the urine, and sugar was found in a small
amount for a short period of three days, although the glycosuria readily
disappeared by cutting down the carbohydrate intake, the vision came
back to normal more slowly. In fact, it was almost one month before the
symptoms and signs of the retinal change had entirely disappeared. It is
interesting in this connection to recall similar cases referred to in
Allbutt’s System of Medicine, vol. vi, on influenza, following the
epidemic of 1890 in England. Other transient glycosurias showed no
visual changes. We do not consider these to be true cases of diabetes
mellitus. In all a transient hyperglycæmia was also noted.
_Pregnancy_
A condition which can scarcely be considered as a complication of
influenza, but which, however, was a large factor in increasing the
mortality among women, was pregnancy. Among the cases included in this
study were five pregnant women, who came to the hospital and were
referred to the medical service. As soon as a complication relative to
the existing pregnancy arose they were referred to the Obstetrical
Department. On account of the great amount of work in caring for the
influenzal patients, and on account of the scarcity of physicians and
nurses, we were unable to follow these cases closely enough to give any
such definite data as we wish. Three miscarried or went into premature
labor. Happily only one of them died. The two which did not miscarry
recovered and left the hospital well.
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