Читать книгу Studies on Epidemic Influenza: Comprising Clinical and Laboratory Investigations онлайн

51 страница из 69

Assistance from the laboratory was meager, especially in the early days of the epidemic. This was due largely to the inability to get laboratory workers in sufficient numbers to follow the work through, but more largely to the fact that we were unable to interpret the unusual laboratory results which were available. When we were once fully aware of the difficulties in diagnosis which confronted us, we utilized every practical means at our disposal. Among these was an examination of the chest with the X-ray. On account of lack of facilities and of help, it was impossible to make routine X-ray examinations of the chest in all cases. Besides, it was difficult to interpret the X-ray findings, on account of the unusual character of the lesions. Also, many of the patients were so desperately ill one hesitated to disturb them. We hear that other clinics had similar experiences, and that very little substantial help came from the X-ray, except in cases with complications. Several attempts were made to determine the kind of shadow, if any, the “cyanotic, œdematous, wet” lung would make, but no satisfactory observations have been forthcoming. From our own observations and from the discussions of other observers, it would seem to us that the stereoscopic examination of these chests is the only possible way of getting satisfactory plate readings in these cases where the pathology seems so lawless in its extent and peculiar in its distribution. This method of examination, however, demands facilities convenient at the bedside and perfect co-operation of the patient—difficult conditions to meet under the circumstances. In the acute cases, when the desire to make a diagnosis not only of the presence but of the extent of the disease was keen, X-ray examination was largely impractical. In cases of delayed resolution, or in cases with complications with prolonged convalescence, X-ray examinations were extremely helpful.