Part 14

Aplastic serofibrinous, and hemorrhagic, pneumonic exudates.

Necrotizing and organizing bronchiolitis, and pneumonia: lobar, lobular, peribronchial, interstitial.

The sequelæ—obliterating bronchiolitis and bronchiolectasis.

Proliferation of alveolar and bronchiolar epithelium.

The extrarespiratory lesions of influenza are neither constant nor characteristic. Irrespective of localization, they have the same fundamental pathology characterized by:

Vascular damage.

Hemorrhage.

Organization with or without infection.

A basis for the interpretation of the respiratory lesions of influenza is offered by the analogous changes in the respiratory tract initiated by the inhalation of poisonous gases.

The respiratory lesions are dependent primarily upon the damage produced by the true etiological agent and the systemic capacity to compensate, and only secondarily upon invasion by the bacterial flora of the mouth and inspired air.

BIBLIOGRAPHY

1. Abrahams, Hallows, Eyre, and French: Purulent Bronchitis; Its Influenzal and Pneumococcal Bacteriology;—Lancet, 1917, 193, 377.

2. Abrahams, Hallows, and French: A Further Investigation into Influenzo-Pneumococcal and Influenzo-Streptococcal Septicæmia;—Lancet, 1919, 196, 1.

3. Askanazy: Über die Veränderungen der grossen Luftwege, besonders ihre Epithel-Metaplasie bei der Influenza;—Corr. Blatt f. Schweizer Aerzte, 1919, 49, 465.

4. Averill, Young, and Griffiths: The Influenza Epidemic in a Camp;—Brit. Med. J., 1918, 2, 111.

5. Avery, Chickering, Cole, and Dochez: Acute Lobar Pneumonia;—Monograph of the Rockefeller Institute, No. 7.

6. Ballin: Empyema Following Influenzal Pneumonia;—J. A. M. A., 1919, 72, 335.

7. Beals, Blanton, and Eisendrath: Abdominal Complications of the Influenza Epidemic at Camp Custer;—J. A. M. A., 1919, 72, 850.

8. Berkley and Coffen: Generalized Interstitial Emphysema and Spontaneous Pneumothorax;—J. A. M. A., 1919, 72, 535.

9. Bernhardt: Zur Aetiologie der Grippe, 1918;—Med. Klin., 1918, 14, 683.

10. Bircher: Zur Grippe Epidemie;—Corr. Blatt f. Schweizer Aerzte, 1918, 48, 1338.

11. Bland: Influenza in Relation to Pregnancy;—Am. J. of Obs., 1919, 79, 184.

12. Blanton and Irons: Recent Epidemic Respiratory Disease at Camp Custer;—J. A. M. A., 1918, 71, 1988.

13. Blanton, Burhans, and Hunter: Studies in Streptococcic Infections at Camp Custer;—J. A. M. A., 1919, 72, 1520.

14. Bloomfield and Harrop: Clinical Observations on Epidemic Influenza;—Bull. Johns Hopk. Hosp., 1919, 30, 1.

15. Borst: Pathologisch-anatomische Beobachtungen zur “spanischen Grippe” 1918;—Mün. med. Wchnschr., 1918, 65, 1342.

16. Bradford, Bashford, and Wilson: Preliminary Report on the Presence of “Filter Passing” Virus in Certain Diseases;—Brit. Med. J., 1919, 1, 127.

17. Brem, Bolling, and Casper: Pandemic Influenza and Secondary Pneumonia at Camp Fremont;—J. A. M. A., 1918, 71, 2138.