Part 1

Produced by Richard Tonsing and the Online Distributed Proofreading Team at http://www.pgdp.net (This file was produced from images generously made available by The Internet Archive)

PUBLISHED ON THE FOUNDATION ESTABLISHED IN MEMORY OF ANTHONY N. BRADY

FIG. I. AUTOPSY NO. 99. ACUTE HEMORRHAGIC AND ULCERATIVE LARYNGOTRACHEITIS. ]

THE PATHOLOGY OF INFLUENZA

BY M. C. WINTERNITZ, ISABEL M. WASON AND FRANK P. MCNAMARA

FROM THE BRADY LABORATORY OF PATHOLOGY AND BACTERIOLOGY, YALE UNIVERSITY SCHOOL OF MEDICINE AND THE NEW HAVEN HOSPITAL

NEW HAVEN YALE UNIVERSITY PRESS LONDON · HUMPHREY MILFORD · OXFORD UNIVERSITY PRESS MDCCCCXX

COPYRIGHT, 1920, BY YALE UNIVERSITY PRESS

The present volume is the fourth work published by the Yale University Press on the Anthony N. Brady Memorial Foundation, which was established June 15, 1914, by members of the family of the late Anthony N. Brady to enable the University to declare operative the agreement for an alliance between the New Haven Hospital and the Yale School of Medicine. In addition to the pledge of endowment for this purpose, the donors erected for the University on the grounds of the Hospital a clinical and pathological laboratory, and have since, through additional gifts to supplement the income of the Memorial Foundation, made possible the publication of this and other works by members of the faculty of the School of Medicine at Yale.

Our grateful acknowledgment is due the Staff of the New Haven Hospital, especially the members of the Department of Medicine, for their hearty co-operation and for the use of the clinical notes. We also wish to thank the members of the Medical Corps of the United States Army who were stationed at the Yale Army Laboratory School while the work was in progress and who aided in many ways:—Colonel Charles F. Craig, Captain R. A. Lambert, Lieutenants C. A. McKinlay, Frederick Parker, Jr., Ellis Kellert, Henry R. Muller, and J. H. Globus.

------------------------------------------------------------------------

TABLE OF CONTENTS

Page

Introduction 9

I. The Pathology of the Respiratory Tract in Influenza 13

(A) Lesions of the Trachea and Bronchi 13

(a) Gross Picture 13 (b) Histological Picture 14 (c) Summary 16

(B) Lesions of the Lung 16

(1) Acute Diffuse Fulminating Type 18

(a) Gross Picture 18 (b) Summary 19 (c) Histological Picture 20 (d) Summary 22

(2) Localization and Necrotization of the Pneumonic Process 22

(a) Gross Picture 22 (b) Histological Picture 24 (c) Summary 26

(3) Organization of the Bronchiolar and Pneumonic Processes 26

(a) Illustrative Protocols 27 (b) Summary 30

II. Influence of the Respiratory Complications of Influenza upon Tuberculosis of the Lung 32

(a) Illustrative Protocols 32 (b) Summary 33

III. Extrarespiratory Lesions in Influenza 34

(A) Lesions of the Hematopoietic System 34