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Clinically the cases fell into four main groups: (1) Lobar pneumonia; (2) lobar pneumonia with purulent bronchitis; (3) bronchopneumonia (pneumococcus); (4) bronchopneumonia (streptococcus). It should be borne in mind, however, that the picture was a complex one and that correct clinical interpretation was not always possible, since many cases did not conform sharply to any one type and superimposed infections during the course of the disease often modified the picture.

Pneumococcus Pneumonia Following Influenza.

Table XIVTypes of Pneumococcus in 105 Cases of Pneumococcus Pneumonia Following InfluenzaLOBAR PNEUMONIABRONCHOPNEUMONIATOTALPER CENTPneumococcus, Type I887.6Pneumococcus, Type II3143.8Pneumococcus, II atyp.127918.1Pneumococcus, Type III3365.7Pneumococcus, Group IV32366864.8

The most noteworthy feature of the figures in Table XIV is the high proportion of pneumonias due to types of pneumococci found in the mouths of normal individuals, 93 cases or 88.6 per cent, being caused by Pneumococcus Types II atypical, III, and IV. This is in harmony with the results generally reported and is in all probability due to the fact that in patients with influenza pneumococci, which under normal conditions would fail to cause pneumonia, readily gain access to the respiratory tract and produce the disease. It is also of interest that with one exception the highly parasitic pneumococci of Types I and II were associated with pneumonias clinically lobar in type.