Читать книгу Epidemic Respiratory Disease. The pneumonias and other infections of the repiratory tract accompanying influenza and measles онлайн

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The sum and substance of opinion in 1918 would seem to be best summarized by quoting from the published report compiled by the British Medical Research Commission:^[20] “Although Pfeiffer may yet furnish reasons why the verdict should not be pronounced, there is already sufficient material to shake the orthodox conception out of its high altar. Two facts stand out prominently: the generally acknowledged, or by some reluctantly admitted, absence of B. influenzæ from organs on postmortem examinations, and the universally recorded findings of diplostreptococci, singly or in association with the Pfeiffer bacillus.” Comment on this opinion will be made in the general discussion at the end of this paper.

In undertaking a study of the bacteriology of influenza, it seemed essential to bear in mind certain clinical features of the disease which will be discussed in greater detail in a subsequent paper. It suffices to say for our present purpose that it is felt that influenza in itself should be regarded as a self-limited disease of short duration (two to five days in most instances), the most prominent local manifestation of which is a rapidly progressing attack upon the mucous membranes of the respiratory tract. Among the cases observed during the epidemic at Camp Pike uncomplicated influenza never proved fatal and death invariably was associated with a complicating pneumonia. In a large majority of cases pneumococci, S. hemolyticus, or less frequently other bacteria in addition to B. influenzæ were associated with the pneumonia. It is felt, therefore, that in any attempt to determine the primary cause of influenza bacteriologic studies made during life in early uncomplicated cases of the disease are of primary importance and that the bacteriology of the sputum of patients with complicating pneumonia and the bacteriology of autopsies can only properly be used as valuable supplements to data so obtained.