The pathology of influenzaWinternitz, M. C. (Milton C.)
Science
The pathology of influenza
Winternitz, M. C. (Milton C.)
Influenza
The well developed post-mortem muscular rigidity, the lividity of the
dependent parts, of the face with its mucous membranes, and often of the
trunk, the jaundice variable in extent, the crusts of blood on the nares
and mouth, and the splanchnic dilatation are features which prepare for
the gross picture presented by the thoracic organs. The increased
moisture within the pleural cavities associated with the even,
translucent pleural surface, whose dilated lymphatics become more and
more prominent towards the hilum, the large succulent lymph glands, and
the exudate in the bronchial tree, are all striking, but more
characteristic of the gross picture, is the great increase in volume of
the lung itself, mottled with brilliant colors. The lung, too, is very
wet and on section, after the syrupy, blood-stained fluid escapes from
the less definitely consolidated zones, the latter appear, not as the
usual granular, firm areas of hepatization, but have more the
consistency of a gel, and also its translucence. Characteristic of this
disease as these changes may be, the specificity of the fundamental
lesion in the respiratory tract, becomes more emphatic after study of
its histology (92, 162).
_Histological Picture._
No matter what the portion of the lung from which the sections are
derived, the fundamental changes found are the same. The subpleural
sheets are spread wide apart, now by empty spaces, now by coagulated
fluid. The process extends from the surface through the interlobular
septa (Fig. XX), and is accentuated where the connective tissue is more
prominent around vessels and bronchi. The nature of the infiltrate in
the subpleural and interstitial tissues becomes more evident in the
alveoli, which likewise are filled. The material varies somewhat in
appearance, probably dependent upon its proteid content. Not
infrequently the alveoli contain a homogeneous, pink-staining mass,
which resembles the colloid of the thyroid gland. Again, it may be
simply a coarse granular precipitate (Fig. XXIII), and in still other
instances, small sticks and strands form the bulk of the alveolar
content (47, 92, 140, 156). This subpleural, interstitial, perivascular,
peribronchial, and alveolar edema, which is a term applicable to this
collection of fluid, is very prominent, and although its intensity
varies in different portions of the lung; and although it may be
replaced in some areas by other types of exudate, unquestionably, this
is the dominating expression of the inflammatory process in the early
stage of the disease.
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