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Table XVCases of Lobar Pneumonia Following InfluenzaCASEONSET OF INFLUENZAONSET OF PNEUMONIASPUTUM EXAMINATIONCOURSE OF PNEUMONIANECROPSYDATEBACTERIOLOGYDIAGNOSISBACTERIOLOGYPulSept. 7Sept. 9 1st attack bronchopn.Sept. 10Pn. IV ++++ B. inf. +++Recovery by crisis on Sept. 14. On Sept. 21 developed lobar pneumonia. Died Sept. 30Lobar pneumonia. Gray hepatization L.L, L.U, R.L.H.B. Pn. II Br. Pn. II ++++ B. inf. +++ R.L. Pn. II + +LewSept. 16Sept. 20 chillSept. 22Pn. I +++ B. inf. +Lobar pn., recovery by crisis Sept. 29. Developed 2nd attack lobar pn. on Oct. 2. Died Oct. 8Lobar pneumonia. Gray hepatization R.U. Fibrinopurulent pleurisyH.B. Pn. II atyp. Br. B. inf. ++++ Pn. IIa +++ S. hem. + Staph. + R.U. Pn. IIa ++++ColSept. 20Sept. 24Sept. 27Pn. IV ++Severe lobar pneumonia. Died on Sept. 30Lobar pneumonia. Red hepatization all lobes. Serofibrinous pl., rt. 125 c.c.H.B. S. hem. Br. S. hem. ++++ Staph. + L.L. S. hem. ++++ Staph. +GarSept. 23Sept. 28Sept. 30Pn. IV ++ S. hem. + B. inf. +Fulminating rapidly fatal lobar pneumonia. Died Sept. 30Lobar pneumonia. Engorgement and red hepatization L.U., R.U.H.B. S. hem. Br. S. hem. ++++ B. inf. +++ L.U. S. hem. ++++HolSept. 25Sept. 30Sept. 30Pn. III ++ B. inf. ++Fulminating rapidly fatal lobar pneumonia. Died Oct. 1.Lobar pneumonia. Engorgement all lobesH.B. sterile Br. B. inf. ++++ Pn. III ++ S. hem. + R.L. Pn. III ++++ B. inf. ++ S. hem. +L.L. R.L., etc., indicates lobes involved. H. B. = Heart’s blood. Br. = bronchus.

(2) There were 11 cases of lobar pneumonia with purulent bronchitis in the group studied. Clinically, they closely resembled the cases in the preceding group except in so far as the picture was modified by the presence of the purulent bronchitis. All directly followed influenza. The sputum, instead of being rusty and tenacious, was profuse and mucopurulent, usually streaked with blood. Stained films and direct culture on blood agar plates showed pneumococci in abundance and B. influenzæ in varying numbers, in only two instances the predominant organism. The physical signs were those of lobar pneumonia with, in addition, those of a diffuse bronchitis as manifested by medium and coarse moist râles throughout both chests. Five cases recovered by crisis; 6 terminated fatally and in all of them the clinical diagnosis of lobar pneumonia with purulent bronchitis was confirmed at necropsy.